Transplant Manitoba, Gift of Life Program, Shared Health Manitoba, Winnipeg, Manitoba, Canada; Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Canadian Donation and Transplantation Research Program, Edmonton, Alberta, Canada.
Division of Nephrology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Am J Transplant. 2023 Jun;23(6):707-726. doi: 10.1016/j.ajt.2023.03.016. Epub 2023 Mar 29.
Sexual orientation and gender identity (SOGI)-diverse populations experience discrimination in organ and tissue donation and transplantation (OTDT) systems globally. We assembled a multidisciplinary group of clinical experts as well as SOGI-diverse patient and public partners and conducted a scoping review including citations on the experiences of SOGI-diverse persons in OTDT systems globally to identify and explore the inequities that exist with regards to living and deceased OTDT. Using scoping review methods, we conducted a systematic literature search of relevant electronic databases from 1970 to 2021 including a grey literature search. We identified and screened 2402 references and included 87 unique publications. Two researchers independently coded data in included publications in duplicate. We conducted a best-fit framework synthesis paired with an inductive thematic analysis to identify synthesized benefits, harms, inequities, justification of inequities, recommendations to mitigate inequities, laws and regulations, as well as knowledge and implementation gaps regarding SOGI-diverse identities in OTDT systems. We identified numerous harms and inequities for SOGI-diverse populations in OTDT systems. There were no published benefits of SOGI-diverse identities in OTDT systems. We summarized recommendations for the promotion of equity for SOGI-diverse populations and identified gaps that can serve as targets for action moving forward.
性取向和性别认同（SOGI）多样化的人群在全球的器官和组织捐赠和移植（OTDT）系统中经历歧视。我们召集了一组多学科的临床专家以及 SOGI 多样化的患者和公众合作伙伴，并进行了范围综述，包括对全球 OTDT 系统中 SOGI 多样化人群的经验的引用，以确定和探讨与活体和已故 OTDT 相关的不平等问题。使用范围综述方法，我们对从 1970 年到 2021 年的相关电子数据库进行了系统文献搜索，包括灰色文献搜索。我们确定并筛选了 2402 条参考文献，并纳入了 87 篇独特的出版物。两名研究人员独立地对纳入出版物中的数据进行了双重编码。我们进行了最佳拟合框架综合分析，并结合了归纳主题分析，以确定在 OTDT 系统中对 SOGI 多样化身份的综合效益、危害、不平等、不平等的合理性、减轻不平等的建议、法律和法规，以及有关 SOGI 多样化身份的知识和实施差距。我们在 OTDT 系统中确定了 SOGI 多样化人群的许多危害和不平等。在 OTDT 系统中，SOGI 多样化身份没有发表的益处。我们总结了促进 SOGI 多样化人群公平的建议，并确定了可以作为未来行动目标的差距。
