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

^*Corresponding author for this work

Medicine, Nephrology Division

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

20 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

Funding

This conference was supported by the Department of Surgery at the University of Colorado Anschutz Medical Campus and the Colorado Center for Transplantation Care, Research, and Education (CCTCARE).

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

Transplantation
Pharmacology (medical)
Immunology and Allergy

Access to Document

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

@article{903da4bcb0934e1f9356fa7227190a37,

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",

month = mar,

doi = "10.1016/j.ajt.2022.11.008",

language = "English (US)",

volume = "23",

pages = "316--325",

journal = "American Journal of Transplantation",

issn = "1600-6135",

publisher = "Elsevier B.V.",

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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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T1 - Addressing sex-based disparities in solid organ transplantation in the United States – a conference report

AU - Sawinski, Deirdre

AU - Lai, Jennifer C.

AU - Pinney, Sean

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

AU - Perez, Richard V.

AU - Schold, Jesse D.

AU - Turgeon, Nicole A.

AU - Kobashigawa, Jon

AU - Kukreja, Jasleen

AU - Magee, John C.

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

PY - 2023/3

Y1 - 2023/3

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.

AB - 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.

KW - disparities

KW - ethics and public policy

KW - heart transplant

KW - kidney transplant

KW - liver transplant

KW - lung transplant

KW - organ allocation

KW - organ procurement and allocation

KW - sex disparities

KW - solid organ transplantation

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AN - SCOPUS:85149883086

SN - 1600-6135

VL - 23

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JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 3

ER -

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

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