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Sex Differences in Cardiac Transplantation

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Abstract

Purpose of Review

The goal of this review was to summarize contemporary evidence surrounding sex differences in heart transplantation (HT).

Recent Findings

Women have steadily comprised approximately 25% of waitlist candidates and HT recipients. This disparity is likely multifactorial with possible explanations including barriers in referral to advanced heart failure providers, implicit bias, and concerns surrounding sensitization. Women continue to experience higher waitlist mortality at the highest priority tiers. After HT, there are differences in post-transplant complications and outcomes. Future areas of study should include sex differences in noninvasive surveillance, renal outcomes after transplantation, and patient-reported outcomes.

Summary

There are important sex-specific considerations that impact candidate selection, donor matching, waitlist and post-transplant outcomes. Concerted efforts are needed to improve referral patterns to ensure transplantation is allocated equally.

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Authors and Affiliations

  1. Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Alice Chung

  2. Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA

    Heidi Hartman

  3. Center for Advanced Cardiac Care, Division of Cardiology, Columbia University Irving Medical Center, 622 West 168th Street, PH 12-1284, New York, NY, 10032, USA

    Ersilia M. DeFilippis

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  1. Alice Chung
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A.C drafted the initial manuscript. H.H and E.M.D provided critical feedback and revisions. All authors reviewed the final manuscript.

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Correspondence to Ersilia M. DeFilippis.

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Chung, A., Hartman, H. & DeFilippis, E.M. Sex Differences in Cardiac Transplantation. Curr Atheroscler Rep 25, 995–1001 (2023). https://doi.org/10.1007/s11883-023-01169-0

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