Women Still Receive Fewer Lung Transplants – respiratory-therapy.com

Report on Gender Disparities in Lung Transplantation and Alignment with Sustainable Development Goals

Executive Summary

A recent study by UCLA Health indicates that significant gender-based disparities persist in the allocation of lung transplants within the United States, despite recent policy revisions. This inequality directly challenges the principles of several United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). The findings reveal that systemic barriers continue to disadvantage female candidates, highlighting an urgent need for further policy refinement to ensure equitable access to life-saving healthcare.

Key Findings on Organ Allocation Disparities

1. Persistent Gender Gap: Following the implementation of the new Composite Allocation Score (CAS) system in March 2023, female lung transplant candidates remain 16% less likely than their male counterparts to receive a transplant. This marks only a modest improvement from the previous system, under which women were 32% less likely to undergo transplantation.
2. Contributing Factors: The disparity is attributed to a combination of biological and social factors. Women’s smaller average body size limits the pool of physically compatible donor lungs. Furthermore, women are more likely to have developed antibodies from pregnancies or blood transfusions, which increases immune sensitivity and reduces the number of immunologically compatible donors.
3. Policy Impact: While the CAS system was designed to improve fairness by incorporating variables like height and immune sensitivity, the data demonstrates that it has not fully resolved the existing gender inequality. The system requires further refinement to create a truly equitable allocation process.

Analysis in the Context of Sustainable Development Goals

The continued disparity in lung transplant allocation represents a significant challenge to the achievement of key SDGs:

• SDG 3: Good Health and Well-being: This goal aims to ensure healthy lives and promote well-being for all at all ages. The systemic barriers preventing women from equitably accessing lung transplants directly undermine this objective by creating unequal health outcomes based on gender.
• SDG 5: Gender Equality: The findings illustrate a clear case of gender inequality in access to critical healthcare services. Achieving SDG 5 requires the elimination of all forms of discrimination against women, including systemic biases within healthcare policies and allocation systems that limit their opportunities for life-saving treatment.
• SDG 10: Reduced Inequalities: This goal calls for reducing inequality within and among countries. The gender gap in organ allocation is a stark example of an internal inequality that denies a specific demographic group equal opportunity. Addressing this disparity is essential for progress toward a more just and equitable society.

Conclusion and Recommendations

The research confirms that while progress has been made, the current organ allocation system is insufficient to guarantee gender equity in lung transplantation. To align with the global commitments outlined in the Sustainable Development Goals, further revisions to the Composite Allocation Score are imperative. It is recommended that policymakers and the Organ Procurement and Transplantation Network (OPTN) prioritize additional refinements to the scoring system. Ensuring a fair and effective organ allocation process for all patients, regardless of gender, is a critical step toward achieving universal health coverage, promoting gender equality, and reducing systemic inequalities.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article directly relates to health outcomes, specifically the accessibility of life-saving lung transplants. It discusses the challenges and systems in place for organ allocation, which is a critical component of advanced healthcare services and ensuring healthy lives for all.

• SDG 5: Gender Equality

  This is a central theme of the article. The research highlights a persistent disparity where “female lung transplant candidates continue to be 16% less likely to undergo transplant” than their male counterparts. The entire discussion revolves around identifying and addressing this gender-based inequality in healthcare access.

• SDG 10: Reduced Inequalities

  The article focuses on inequality of outcome between different groups (men and women) within the healthcare system. It examines how policies like the Composite Allocation Score (CAS) are intended to reduce these disparities, aligning with the goal of ensuring equal opportunity and reducing inequalities for all.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3: Good Health and Well-being

  • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article’s focus on equitable access to lung transplantation directly addresses the “access to quality essential health-care services” component of this target.

• SDG 5: Gender Equality

  • Target 5.1: End all forms of discrimination against all women and girls everywhere. The disparity in transplant access, where women are less likely to receive an organ due to systemic and biological factors not fully accounted for in policy, can be seen as a form of systemic discrimination that this target aims to eliminate.
  • Target 5.c: Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels. The article explicitly discusses the implementation and impact of policies (LAS and CAS) designed to create a more equitable organ allocation system, and calls for “further refinements,” which aligns perfectly with this target.

• SDG 10: Reduced Inequalities

  • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status. The article’s core issue is the unequal access to healthcare based on sex, and the efforts to reform the allocation system are aimed at promoting the inclusion of women in receiving this life-saving procedure.
  • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard. The article directly addresses an “inequality of outcome” (receiving a transplant) and analyzes the effectiveness of policies (CAS) designed to reduce this disparity.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Gender Disparity Rate in Lung Transplants

  The article provides explicit quantitative data that serves as a direct indicator. It states that before the new policy, “women were 32% less likely than men to receive a lung transplant.” After the policy change, “women were 16% less likely to undergo transplantation.” This percentage difference is a clear, measurable indicator of the inequality gap and can be used to track progress towards targets 5.1 and 10.3.

• Policy and System Refinements

  The implementation and evolution of the organ allocation systems (from LAS to CAS) is an indicator of action towards Target 5.c. The article mentions that the CAS system “added variables such as height, blood type, and immune sensitivity to better match donors and recipients.” The existence and specific components of such policies serve as an indicator of efforts to create a fairer system. The call for “further refinements” implies that the continuous improvement of this policy is also a measure of progress.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.

Source: respiratory-therapy.com