The sex disparity in liver transplantation.

IF 1.8 4区医学 Q3 TRANSPLANTATION

Current Opinion in Organ Transplantation Pub Date : 2023-08-01 Epub Date: 2023-06-09 DOI:10.1097/MOT.0000000000001081

Rachel Hogen, Matthew Hunter Witt, Kiran Dhanireddy

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引用次数: 0

Abstract

Purpose of the review: This review describes the sex disparity in liver transplantation (LT) and explains its underlying causes.

Recent findings: There is a small but persistent sex disparity in transplant rate and waitlist mortality that disappears once women are listed as Status 1. Allocation systems that could replace the Model for End Stage Liver Disease (MELD)-Na with scores less reliant on serum creatine and muscle mass have the potential to alleviate part of the sex disparity. Women perform worse on frailty assessments and are more likely to have nonalcoholic steatohepatitis (NASH). A diagnosis of NASH is compounding risk factor for frailty.

Summary: Women remain disadvantaged in their access to LT despite multiple evolutions of the allocation system. An allocation system that relies less heavily on serum creatinine could partially alleviate the sex disparity. As NASH becomes more prevalent and frailty becomes more important in listing decisions, we may also need to carefully consider differences in the manifestations of frailty between the genders.

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肝脏移植手术中的性别差异。

综述的目的：本综述描述了肝移植（LT）中的性别差异，并解释了其根本原因：在移植率和等待者死亡率方面，性别差异虽小，但持续存在，一旦女性被列为 "状态 1"，性别差异就会消失。用不太依赖血清肌酸和肌肉质量的评分来取代肝病终末期模型（MELD）-Na的分配系统有可能缓解部分性别差异。女性在虚弱评估中的表现更差，更有可能患有非酒精性脂肪性肝炎（NASH）。总结：尽管分配制度经历了多次演变，但女性在获得低温治疗方面仍然处于不利地位。减少对血清肌酐依赖的分配制度可以部分缓解性别差异。随着 NASH 的发病率越来越高，虚弱程度在上市决策中变得越来越重要，我们可能还需要仔细考虑两性之间虚弱表现的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.