Editorial: Disparities in transplantation access and outcomes: mind the gap!

Abstract

Organ transplantation still remains a problem of supply and demand and presents multiple ethical challenges to our society. Despite numerous targeted interventions and policy reforms, women, underrepresented minorities and patients with low socioeconomic status (SES) continue to have unequal access to transplant. The purpose of this special edition is to highlight disparities in access to transplantation and posttransplant outcomes. Acknowledging that these disparities exist is the first step toward interventions aimed at mitigating this long-standing inequity. This issue provides 10 articles that give the background and summarize relevant literature describing these disparities and identify potential areas of intervention. Most of the data relates to the United States but may reflect patterns encounter in most societies. Each manuscript was written by leaders of international teams in the field of patient advocacy, public health or outcome research in transplantation.

Gender disparities in kidney replacement therapies and transplantation in Colombia

“…Nevertheless, prevalence of CKD has shown substantial differences between men and women, as well as the rate of progression [ 4 , 6 ]. CKD prevalence worldwide has been reported to be higher in female, with the exception of Japan and Singapore [ 4 , 7 ].…”

“…When the donor is female and the recipient is older than 45 years old, there is a lower risk of graft loss when compared to a male of the same age [ 3 ]. There exists a different hypothesis about the diverse aspects which could contribute to these observations, which include immunological reaction in female recipients to HY antigen (male tissues) [ 21 ], the immunostimulatory effect of estrogen [ 3 , 4 , 7 ] and the opposed immunosuppressive effect of testosterone [ 3 , 4 ].…”

“…Since men are favored in the process, a gender inequity is created in which women have been recognized as disadvantaged even after several efforts [ 5 ]. This inequity has been repetitively proven through data analysis of the US databases [ 6 , 7 ]. It has been a common interest worldwide to recognize the impact of gender on equity and access to transplantation.…”