Addressing sex-based disparities in solid organ transplantation in the United States – a conference report

Deirdre Sawinski; Jennifer C. Lai; Sean Pinney; Alice L. Gray; Annette M. Jackson; Darren Stewart; Deborah Jo Levine; Jayme E. Locke; James J. Pomposelli; Matthew G. Hartwig; Shelley A. Hall; Darshana M. Dadhania; Rebecca Cogswell; Richard V. Perez; Jesse D. Schold; Nicole A. Turgeon; Jon Kobashigawa; Jasleen Kukreja; John C. Magee; John Friedewald; John S. Gill; Gabriel Loor; Julie K. Heimbach; Elizabeth C. Verna; Mary Norine Walsh; Norah Terrault; Guiliano Testa; Joshua M. Diamond; Peter P. Reese; Kimberly Brown; Susan Orloff; Maryjane A. Farr; Kim M. Olthoff; Mark Siegler; Nancy Ascher; Sandy Feng; Bruce Kaplan; Elizabeth Pomfret

doi:10.1016/j.ajt.2022.11.008

Addressing sex-based disparities in solid organ transplantation in the United States – a conference report

Deirdre Sawinski, Jennifer C. Lai, Sean Pinney, Alice L. Gray, Annette M. Jackson, Darren Stewart, Deborah Jo Levine, Jayme E. Locke, James J. Pomposelli, Matthew G. Hartwig, Shelley A. Hall, Darshana M. Dadhania, Rebecca Cogswell, Richard V. Perez, Jesse D. Schold, Nicole A. Turgeon, Jon Kobashigawa, Jasleen Kukreja, John C. Magee, John FriedewaldJohn S. Gill, Gabriel Loor, Julie K. Heimbach, Elizabeth C. Verna, Mary Norine Walsh, Norah Terrault, Guiliano Testa, Joshua M. Diamond, Peter P. Reese, Kimberly Brown, Susan Orloff, Maryjane A. Farr, Kim M. Olthoff, Mark Siegler, Nancy Ascher, Sandy Feng, Bruce Kaplan, Elizabeth Pomfret

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	316-325
Number of pages	10
Journal	American Journal of Transplantation
Volume	23
Issue number	3
DOIs	https://doi.org/10.1016/j.ajt.2022.11.008
State	Published - Mar 2023
Externally published	Yes

Keywords

disparities
ethics and public policy
heart transplant
kidney transplant
liver transplant
lung transplant
organ allocation
organ procurement and allocation
sex disparities
solid organ transplantation

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

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10.1016/j.ajt.2022.11.008

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Sawinski, D., Lai, J. C., Pinney, S., Gray, A. L., Jackson, A. M., Stewart, D., Levine, D. J., Locke, J. E., Pomposelli, J. J., Hartwig, M. G., Hall, S. A., Dadhania, D. M., Cogswell, R., Perez, R. V., Schold, J. D., Turgeon, N. A., Kobashigawa, J., Kukreja, J., Magee, J. C., ... Pomfret, E. (2023). Addressing sex-based disparities in solid organ transplantation in the United States – a conference report. American Journal of Transplantation, 23(3), 316-325. https://doi.org/10.1016/j.ajt.2022.11.008

Sawinski, D, Lai, JC, Pinney, S, Gray, AL, Jackson, AM, Stewart, D, Levine, DJ, Locke, JE, Pomposelli, JJ, Hartwig, MG, Hall, SA, Dadhania, DM, Cogswell, R, Perez, RV, Schold, JD, Turgeon, NA, Kobashigawa, J, Kukreja, J, Magee, JC, Friedewald, J, Gill, JS, Loor, G, Heimbach, JK, Verna, EC, Walsh, MN, Terrault, N, Testa, G, Diamond, JM, Reese, PP, Brown, K, Orloff, S, Farr, MA, Olthoff, KM, Siegler, M, Ascher, N, Feng, S, Kaplan, B & Pomfret, E 2023, 'Addressing sex-based disparities in solid organ transplantation in the United States – a conference report', American Journal of Transplantation, vol. 23, no. 3, pp. 316-325. https://doi.org/10.1016/j.ajt.2022.11.008

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title = "Addressing sex-based disparities in solid organ transplantation in the United States – a conference report",

abstract = "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.",

keywords = "disparities, ethics and public policy, heart transplant, kidney transplant, liver transplant, lung transplant, organ allocation, organ procurement and allocation, sex disparities, solid organ transplantation",

author = "Deirdre Sawinski and Lai, {Jennifer C.} and Sean Pinney and Gray, {Alice L.} and Jackson, {Annette M.} and Darren Stewart and Levine, {Deborah Jo} and Locke, {Jayme E.} and Pomposelli, {James J.} and Hartwig, {Matthew G.} and Hall, {Shelley A.} and Dadhania, {Darshana M.} and Rebecca Cogswell and Perez, {Richard V.} and Schold, {Jesse D.} and Turgeon, {Nicole A.} and Jon Kobashigawa and Jasleen Kukreja and Magee, {John C.} and John Friedewald and Gill, {John S.} and Gabriel Loor and Heimbach, {Julie K.} and Verna, {Elizabeth C.} and Walsh, {Mary Norine} and Norah Terrault and Guiliano Testa and Diamond, {Joshua M.} and Reese, {Peter P.} and Kimberly Brown and Susan Orloff and Farr, {Maryjane A.} and Olthoff, {Kim M.} and Mark Siegler and Nancy Ascher and Sandy Feng and Bruce Kaplan and Elizabeth Pomfret",

note = "Publisher Copyright: {\textcopyright} 2022 American Society of Transplantation & American Society of Transplant Surgeons",

year = "2023",

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AU - Gray, Alice L.

AU - Jackson, Annette M.

AU - Stewart, Darren

AU - Levine, Deborah Jo

AU - Locke, Jayme E.

AU - Pomposelli, James J.

AU - Hartwig, Matthew G.

AU - Hall, Shelley A.

AU - Dadhania, Darshana M.

AU - Cogswell, Rebecca

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AU - Turgeon, Nicole A.

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AU - Friedewald, John

AU - Gill, John S.

AU - Loor, Gabriel

AU - Heimbach, Julie K.

AU - Verna, Elizabeth C.

AU - Walsh, Mary Norine

AU - Terrault, Norah

AU - Testa, Guiliano

AU - Diamond, Joshua M.

AU - Reese, Peter P.

AU - Brown, Kimberly

AU - Orloff, Susan

AU - Farr, Maryjane A.

AU - Olthoff, Kim M.

AU - Siegler, Mark

AU - Ascher, Nancy

AU - Feng, Sandy

AU - Kaplan, Bruce

AU - Pomfret, Elizabeth

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N2 - 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.

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KW - ethics and public policy

KW - heart transplant

KW - kidney transplant

KW - liver transplant

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Addressing sex-based disparities in solid organ transplantation in the United States – a conference report

Abstract

Keywords

ASJC Scopus subject areas

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