Sex and Gender Disparities in Living Kidney Donation: A Scoping Review
Background. Women are more likely than men to be living kidney donors. We summarized the evidence concerning the reasons behind sex and gender disparities in living kidney donation (LKD). Methods. A scoping review of quantitative and qualitative evidence on reasons for sex and gender disparities in...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-09-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001530 |
| _version_ | 1797732763552448512 |
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| author | Eswari Vilayur, MClinEpi Anita van Zwieten, PhD Mingxing Chen, BSc Anna Francis, PhD Melanie Wyld, PhD Siah Kim, PhD Tess Cooper, MPH Germaine Wong, PhD |
| author_facet | Eswari Vilayur, MClinEpi Anita van Zwieten, PhD Mingxing Chen, BSc Anna Francis, PhD Melanie Wyld, PhD Siah Kim, PhD Tess Cooper, MPH Germaine Wong, PhD |
| author_sort | Eswari Vilayur, MClinEpi |
| collection | DOAJ |
| description | Background. Women are more likely than men to be living kidney donors. We summarized the evidence concerning the reasons behind sex and gender disparities in living kidney donation (LKD).
Methods. A scoping review of quantitative and qualitative evidence on reasons for sex and gender disparities in LKD was conducted from inception to March 2023.
Results. Of 1123 studies screened, 45 were eligible for inclusion. Most studies were from North America, Europe, and Central Asia (n = 33, 73%). A predominance of women as living donors (55%–65%) was observed in 15 out of 18 (83%) studies. Reasons for sex and gender disparities in LKD included socioeconomic, biological, and cognitive or emotional factors. A gendered division of roles within the families was observed in most studies, with men being the primary income earner and women being the main caregiver. Fear of loss of income was a barrier to male donation. Human leukocyte antigen sensitization through pregnancy in female recipients precluded male partner donation, whereas female donation was supported by altruism and a positive attitude toward LKD.
Conclusions. Sex imbalance in LKD is prevalent, with a predominance of women as living donors. Such disparities are driven by societal and cultural perceptions of gender roles, pregnancy-induced sensitization, and attitudes toward donation and at least some of these factors are modifiable. Donor compensation to support predonation assessments and income loss, implementation of innovative desensitization treatments, promotion of paired kidney exchange program, and targeted educational initiatives to promote equitable living donation may help to close the gender gap in LKD. |
| first_indexed | 2024-03-12T12:19:14Z |
| format | Article |
| id | doaj.art-f20d8f57d52348d38f6491d58eaf828c |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-03-12T12:19:14Z |
| publishDate | 2023-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-f20d8f57d52348d38f6491d58eaf828c2023-08-30T06:46:18ZengWolters KluwerTransplantation Direct2373-87312023-09-0199e153010.1097/TXD.0000000000001530202309000-00008Sex and Gender Disparities in Living Kidney Donation: A Scoping ReviewEswari Vilayur, MClinEpi0Anita van Zwieten, PhD1Mingxing Chen, BSc2Anna Francis, PhD3Melanie Wyld, PhD4Siah Kim, PhD5Tess Cooper, MPH6Germaine Wong, PhD71 John Hunter Hospital, Hunter New England Health Service, New Lambton, NSW, Australia.2 Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.4 Centre for Kidney and Transplantation Research, Westmead Hospital, Westmead, NSW, Australia.5 Department of Nephrology, Queensland Children’s Hospital, Brisbane, QLD, Australia.2 Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.2 Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.2 Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.2 Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.Background. Women are more likely than men to be living kidney donors. We summarized the evidence concerning the reasons behind sex and gender disparities in living kidney donation (LKD). Methods. A scoping review of quantitative and qualitative evidence on reasons for sex and gender disparities in LKD was conducted from inception to March 2023. Results. Of 1123 studies screened, 45 were eligible for inclusion. Most studies were from North America, Europe, and Central Asia (n = 33, 73%). A predominance of women as living donors (55%–65%) was observed in 15 out of 18 (83%) studies. Reasons for sex and gender disparities in LKD included socioeconomic, biological, and cognitive or emotional factors. A gendered division of roles within the families was observed in most studies, with men being the primary income earner and women being the main caregiver. Fear of loss of income was a barrier to male donation. Human leukocyte antigen sensitization through pregnancy in female recipients precluded male partner donation, whereas female donation was supported by altruism and a positive attitude toward LKD. Conclusions. Sex imbalance in LKD is prevalent, with a predominance of women as living donors. Such disparities are driven by societal and cultural perceptions of gender roles, pregnancy-induced sensitization, and attitudes toward donation and at least some of these factors are modifiable. Donor compensation to support predonation assessments and income loss, implementation of innovative desensitization treatments, promotion of paired kidney exchange program, and targeted educational initiatives to promote equitable living donation may help to close the gender gap in LKD.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001530 |
| spellingShingle | Eswari Vilayur, MClinEpi Anita van Zwieten, PhD Mingxing Chen, BSc Anna Francis, PhD Melanie Wyld, PhD Siah Kim, PhD Tess Cooper, MPH Germaine Wong, PhD Sex and Gender Disparities in Living Kidney Donation: A Scoping Review Transplantation Direct |
| title | Sex and Gender Disparities in Living Kidney Donation: A Scoping Review |
| title_full | Sex and Gender Disparities in Living Kidney Donation: A Scoping Review |
| title_fullStr | Sex and Gender Disparities in Living Kidney Donation: A Scoping Review |
| title_full_unstemmed | Sex and Gender Disparities in Living Kidney Donation: A Scoping Review |
| title_short | Sex and Gender Disparities in Living Kidney Donation: A Scoping Review |
| title_sort | sex and gender disparities in living kidney donation a scoping review |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001530 |
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