Increased delay to lung transplantation for women candidates: gender-based disparity matters in the lung transplant trajectory - Inserm - Institut national de la santé et de la recherche médicale
Article Dans Une Revue ERJ Open Research Année : 2025

Increased delay to lung transplantation for women candidates: gender-based disparity matters in the lung transplant trajectory

1 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
2 Team 4 - U1064 Inserm - CR2TI - Team 4 : Deciphering organ immune regulation in inflammation and transplantation (DORI-t)
3 Institut du Thorax [Nantes]
4 Team 3 - U1064 Inserm - CR2TI - Team 3 : Integrative transplantation, HLA, Immunology and genomics of kidney injury
5 LMCE - Laboratoire Matière sous Conditions Extrêmes
6 MEPHI - Microbes évolution phylogénie et infections
7 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
8 Hôpital Nord [CHU - APHM]
9 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
10 HUS - Les Hôpitaux Universitaires de Strasbourg
11 HPPIT - Hypertension pulmonaire : physiopathologie et innovation thérapeutique
12 Hôpital Marie-Lannelongue
13 Hôpital Foch [Suresnes]
14 IVPC - Infections Virales et Pathologie Comparée - UMR 754
15 Service Pneumologie-Allergologie [CHU Toulouse]
16 Pôle Thorax et Vaisseaux [CHU Grenoble]
17 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
18 HEGP - Hôpital Européen Georges Pompidou [APHP]
19 HUB-ULB - Hôpital Erasme = Erasmus Hospital = Erasmus Ziekenhuis
20 AMU - Aix Marseille Université
21 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
22 hpsj - Groupe Hospitalier Paris Saint-Joseph
23 ITX-lab - ITX-lab unité de recherche de l'institut du thorax UMR1087 UMR6291
24 CIC Nantes - Centre d’Investigation Clinique de Nantes

Résumé

Background Lung transplantation (LT) is a highly dynamic segment of solid organ transplantation in which gender plays a central role . Our objective was to investigate the causes of outcome differences between women and men all along the LT pathway. Methods We used data from the COhort in Lung Transplantation (COLT) study (12 participating LT centers). Analyses were performed in three phases: baseline clinical characteristics, peri-transplantation period, and post-transplantation follow-up. Results Overall, 1710 participants (802 women and 908 men) were included in this study. Women were less likely than men to undergo transplantation (91.6% versus 95.6%, p=0.001) and waited longer before transplantation (115 versus 73 days, p<0.001). Female gender and pre-transplant class I anti-HLA antibodies were identified as independent factors associated with longer waiting time duration. Female LT recipients commonly received lungs from height- and sex-matched donors, despite higher female waiting-list mortality and a higher proportion of male donors. Importantly, women with oversized lung transplantation (defined by predicted TLC ratio and weight mismatch) did not have worse survival. The overall post-transplant survival of female recipients was significantly higher than that of male recipients (65.6% versus 57.3%, p<0.001), although the prevalence of specific major LT outcomes did not differ according to gender. Conclusion Women waited longer and were less likely to undergo transplant. Women transplanted with an oversized lung did not have worse survival after transplantation, suggesting that size matching criteria based on pTLC ratio and weight mismatch may be less stringent in this context.
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inserm-04880240 , version 1 (10-01-2025)

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Adrien Tissot, Anne-Sophie Coatanea, Olivia Rousseau, Antoine Roux, Benjamin Coiffard, et al.. Increased delay to lung transplantation for women candidates: gender-based disparity matters in the lung transplant trajectory. ERJ Open Research, 2025, pp.00623-2024. ⟨10.1183/23120541.00623-2024⟩. ⟨inserm-04880240⟩
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