The effect of sex inequality on solid organ transplantation: A systematic review and meta-analysis.
Details
Serval ID
serval:BIB_6D15F8F9A856
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The effect of sex inequality on solid organ transplantation: A systematic review and meta-analysis.
Journal
European journal of internal medicine
ISSN
1879-0828 (Electronic)
ISSN-L
0953-6205
Publication state
Published
Issued date
03/2023
Peer-reviewed
Oui
Volume
109
Pages
58-67
Language
english
Notes
Publication types: Meta-Analysis ; Systematic Review ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Sex disparities are related to biological differences, which may have significant impact on patient and allograft outcomes. The aim was to investigate the impact of sex on clinical and safety outcomes after solid organ transplantation (SOT).
A systematic review and meta-analysis was performed. Observational studies comparing females vs. males after SOT were considered for inclusion after a systematic search of the Pubmed, Cochrane Library, and Web of Science databases conducted from 2016 to 2021. Primary outcome was mortality. PROSPERO register number: CRD42021282615.
After retrieving 1103 studies, 22 observational studies (1,045,380 subjects) were finally deemed eligible for inclusion. Females accounted 36.3% of SOT recipients, but presented significantly lower mortality (odds ratio (OR): 0.87, 95% confidence interval (CI): 0.83-0.92, I <sup>2</sup> =78%). In subgroup analyses, mortality was significantly lower in females undergoing liver (OR: 0.89 95%CI: 0.86-0.92, I <sup>2</sup> =0%) or kidney transplantation (OR: 0.82 95%CI: 0.76-0.89, I <sup>2</sup> =72%). Male sex was consistently reported as a protective factor against hospital readmission. Among the outcomes, allograft dysfunction was influenced by a combination of donor-recipient sex and age. Data on overall infections were inconclusive. Several reports suggest a higher risk of malignancy among males.
Females represent one-third of SOT recipients but have higher survival rates than males after liver and kidney transplantation. The impact on graft dysfunction was heterogeneous. While further research is warranted, our findings should encourage clinicians and researchers to consider sex as a factor when taking decisions regarding SOT management.
A systematic review and meta-analysis was performed. Observational studies comparing females vs. males after SOT were considered for inclusion after a systematic search of the Pubmed, Cochrane Library, and Web of Science databases conducted from 2016 to 2021. Primary outcome was mortality. PROSPERO register number: CRD42021282615.
After retrieving 1103 studies, 22 observational studies (1,045,380 subjects) were finally deemed eligible for inclusion. Females accounted 36.3% of SOT recipients, but presented significantly lower mortality (odds ratio (OR): 0.87, 95% confidence interval (CI): 0.83-0.92, I <sup>2</sup> =78%). In subgroup analyses, mortality was significantly lower in females undergoing liver (OR: 0.89 95%CI: 0.86-0.92, I <sup>2</sup> =0%) or kidney transplantation (OR: 0.82 95%CI: 0.76-0.89, I <sup>2</sup> =72%). Male sex was consistently reported as a protective factor against hospital readmission. Among the outcomes, allograft dysfunction was influenced by a combination of donor-recipient sex and age. Data on overall infections were inconclusive. Several reports suggest a higher risk of malignancy among males.
Females represent one-third of SOT recipients but have higher survival rates than males after liver and kidney transplantation. The impact on graft dysfunction was heterogeneous. While further research is warranted, our findings should encourage clinicians and researchers to consider sex as a factor when taking decisions regarding SOT management.
Keywords
Female, Humans, Male, Organ Transplantation, Kidney Transplantation, Transplantation, Homologous, Transplant Recipients, Liver, Allograft dysfunction, Gender disparities, Kidney transplantation, Liver transplantation, Sex differences, Women
Pubmed
Web of science
Create date
10/01/2023 14:54
Last modification date
08/06/2023 6:54