Sawinski Deirdre, Lai Jennifer C, Pinney Sean, Gray Alice L, Jackson Annette M, Stewart Darren, Levine Deborah Jo, Locke Jayme E, Pomposelli James J, Hartwig Matthew G, Hall Shelley A, Dadhania Darshana M, Cogswell Rebecca, Perez Richard V, Schold Jesse D, Turgeon Nicole A, Kobashigawa Jon, Kukreja Jasleen, Magee John C, Friedewald John, Gill John S, Loor Gabriel, Heimbach Julie K, Verna Elizabeth C, Walsh Mary Norine, Terrault Norah, Testa Guiliano, Diamond Joshua M, Reese Peter P, Brown Kimberly, Orloff Susan, Farr Maryjane A, Olthoff Kim M, Siegler Mark, Ascher Nancy, Feng Sandy, Kaplan Bruce, Pomfret Elizabeth
Weill Cornell Medicine - New York Presbyterian Hospital, New York, New York, USA.
Division of Gastroenterology and Hepatology, University of California, San Francisco, California, USA.
Am J Transplant. 2023 Mar;23(3):316-325. doi: 10.1016/j.ajt.2022.11.008. Epub 2023 Jan 12.
Solid organ transplantation provides the best treatment for end-stage organ failure, but significant sex-based disparities in transplant access exist. On June 25, 2021, a virtual multidisciplinary conference was convened to address sex-based disparities in transplantation. Common themes contributing to sex-based disparities were noted across kidney, liver, heart, and lung transplantation, specifically the existence of barriers to referral and wait listing for women, the pitfalls of using serum creatinine, the issue of donor/recipient size mismatch, approaches to frailty and a higher prevalence of allosensitization among women. In addition, actionable solutions to improve access to transplantation were identified, including alterations to the current allocation system, surgical interventions on donor organs, and the incorporation of objective frailty metrics into the evaluation process. Key knowledge gaps and high-priority areas for future investigation were also discussed.
实体器官移植为终末期器官衰竭提供了最佳治疗方法，但在移植机会方面存在显著的性别差异。2021年6月25日，召开了一次虚拟多学科会议，以解决移植领域的性别差异问题。在肾、肝、心和肺移植中都发现了导致性别差异的共同主题，特别是女性在转诊和列入等待名单方面存在障碍、使用血清肌酐的缺陷、供体/受体大小不匹配的问题、应对虚弱的方法以及女性中致敏的患病率较高。此外，还确定了改善移植机会的可行解决方案，包括改变当前的分配系统、对供体器官进行手术干预，以及将客观的虚弱指标纳入评估过程。还讨论了关键的知识空白和未来研究的高优先领域。
