Women are less likely to receive lung transplants and spend more time on waiting lists, despite showing better long-term survival rates after transplantation.
RT’s Three Key Takeaways:
- Women Face Longer Wait Times: Women wait an average of 115 days for a lung transplant compared to 73 days for men.
- Fewer Transplants for Women: Women are less likely to receive a transplant, with a 91.6% likelihood compared to 95.6% for men.
- Higher Survival Rates for Women: Women who receive lung transplants have a five-year survival rate of 70%, outperforming men’s survival rate of 61%.
Women are less likely to receive a lung transplant and spend an average of six weeks longer on the waiting list, according to a study published in ERJ Open Research.
However, women who receive a lung transplant are more likely than men to live for five years post-transplant. Based on their findings, the researchers encourage changes in regulation and clinical guidelines to address this inequality.
Lung transplantation is the only treatment for people with end-stage respiratory failure and patients on the waiting list have a high risk of death. A transplant can restore normal lung function, giving patients an improved life expectancy and higher quality of life.
“It is important to understand that people on the waiting list for a transplant have a very poor quality of life, sometimes they are not well enough to leave their house, and have a high risk of death,” says lead researcher of the study, Adrien Tissot from Nantes University Hospital, France, in a release. “For these patients, waiting is suffering, and the longer the wait the worse these women are suffering.”
Study Examines Lung Transplant Pathway and Gender Differences in Outcomes
The study included 1710 participants—802 women and 908 men—who were being cared for at one of France’s 12 transplantation centers between 2009 and 2018. Patients were followed up for around six years after transplantation. The main underlying diseases affecting patients were chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease.
Researchers say this study is the first to analyze all three periods of the transplantation pathway in the same group of patients: the period on the waiting list prior to transplantation; the transplantation surgery and immediately afterward; and the months and years after transplantation.
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Tissot’s research found that women wait 115 days for a lung transplant on average versus 73 days for men. Women were also less likely to receive a lung transplant (91.6% vs 95.6%). Previous research has shown that women are also more likely to die on the waiting list.
After transplantation, survival was higher for women than men with 70% of female recipients still alive five years after transplantation, compared to 61% of male recipients.
Donor Matching by Sex and Height May Contribute to Longer Waits for Women
The researchers also found that most women received a donor lung that was matched by sex and height. Researchers say this is important since there is a higher number of male donors (56% of donors), and men are 13cm taller than women on average, which means that women may have to wait longer to get a lung transplant from a height-matched recipient.
Women who received an “oversized” lung generally did not have worse survival after transplantation, suggesting it may be possible to allow more women to receive male donor transplants. This could address some of the gender inequalities on the waiting list.
“Clinicians, patients, and policy makers must acknowledge this gender difference as it’s essential for appropriate action to be taken. Early listing for women or revising allocation policy of donor lung to recipient could be considered,” says Tissot in a release. “We believe our findings, such as the potential role of size matching and its consequence on access to lung transplantation, and length of time on the waiting list, may also apply in other countries where lung transplantation is performed.”
