Women Are Also Disadvantaged in Accessing Transplant Outside the United States: Analysis of the Spanish Liver Transplantation Registry

Marta Tejedor; Fernando Neria; Gloria De La Rosa; Carolina Almohalla Álvarez; María Padilla; Andrea Boscà Robledo; Yiliam Fundora Suárez; Francisco Sánchez-Bueno; Miguel Angel Gómez-Bravo; Marina Berenguer

doi:10.3389/ti.2024.12732

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Women Are Also Disadvantaged in Accessing Transplant Outside the United States: Analysis of the Spanish Liver Transplantation Registry

Journal article

Open access

Peer reviewed

Women Are Also Disadvantaged in Accessing Transplant Outside the United States: Analysis of the Spanish Liver Transplantation Registry

Marta Tejedor, Fernando Neria, Gloria De La Rosa, Carolina Almohalla Álvarez, María Padilla, Andrea Boscà Robledo, Yiliam Fundora Suárez, Francisco Sánchez-Bueno, Miguel Angel Gómez-Bravo and Marina Berenguer

Transplant international, Vol.37, pp.12732-12732

05/07/2024

DOI: 10.3389/ti.2024.12732

PMCID: PMC11106452

PMID: 38773987

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https://doi.org/10.3389/ti.2024.12732View

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Abstract

Sex inequities in liver transplantation (LT) have been documented in several, mostly US-based, studies. Our aim was to describe sex-related differences in access to LT in a system with short waiting times. All adult patients registered in the RETH-Spanish Liver Transplant Registry (2000-2022) for LT were included. Baseline demographics, presence of hepatocellular carcinoma, cause and severity of liver disease, time on the waiting list (WL), access to transplantation, and reasons for removal from the WL were assessed. 14,385 patients were analysed (77% men, 56.2 ± 8.7 years). Model for end-stage liver disease (MELD) score was reported for 5,475 patients (mean value: 16.6 ± 5.7). Women were less likely to receive a transplant than men (OR 0.78, 95% CI 0.63, 0.97) with a trend to a higher risk of exclusion for deterioration (HR 1.17, 95% CI 0.99, 1.38), despite similar disease severity. Women waited longer on the WL (198.6 ± 338.9 vs. 173.3 ± 285.5 days, < 0.001). Recently, women's risk of dropout has reduced, concomitantly with shorter WL times. Even in countries with short waiting times, women are disadvantaged in LT. Policies directed at optimizing the whole LT network should be encouraged to guarantee a fair and equal access of all patients to this life saving resource.

Registries

Spain

United States

Adult

Aged

Carcinoma, Hepatocellular - surgery

End Stage Liver Disease - surgery

Female

Health Services Accessibility - statistics & numerical data

Healthcare Disparities - statistics & numerical data

Humans

Liver Neoplasms - surgery

Liver Transplantation - statistics & numerical data

Male

Middle Aged

Severity of Illness Index

Sex Factors

Waiting Lists

Details

Title: Subtitle: Women Are Also Disadvantaged in Accessing Transplant Outside the United States: Analysis of the Spanish Liver Transplantation Registry
Creators: Marta Tejedor - Hospital Universitario Infanta Leonor
Fernando Neria - Francisco de Vitoria University
Gloria De La Rosa - National Transplant Organization, Madrid, Spain
Carolina Almohalla Álvarez - Scientific Committee of the National Liver Transplant Registry, Madrid, Spain
María Padilla - Organización Nacional de Trasplantes
Andrea Boscà Robledo - Hospital Universitari i Politècnic La Fe
Yiliam Fundora Suárez - Hospital Clínic de Barcelona
Francisco Sánchez-Bueno - Hospital Universitario Virgen del Rocío
Miguel Angel Gómez-Bravo - Hospital Universitario Virgen del Rocío
Marina Berenguer - Instituto de Investigación Sanitaria La Fe
Resource Type: Journal article
Publication Details: Transplant international, Vol.37, pp.12732-12732
DOI: 10.3389/ti.2024.12732
PMID: 38773987
PMCID: PMC11106452
ISSN: 0934-0874
eISSN: 1432-2277
Language: English
Date published: 05/07/2024
Academic Unit: Internal Medicine
Record Identifier: 9984695828902771

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