Editorial: Disparities in transplantation access and outcomes: mind the gap!

Navigating the changing landscape of transplant research: Trends, topics, and gender disparities

BACKGROUND

Transplantation is a rapidly evolving field, reflecting advances in medical science and changing healthcare needs. This study aims to elucidate shifts in research focus over a decade, providing insights into emerging trends in transplant research.

METHODS

We conducted a comprehensive analysis of 9,250 articles published in five high-impact transplant journals from 2012 to 2021. Article titles were processed to extract keywords using R Studio (v. 4.3.0). STATA 18 was used for t-tests and logistic regressions, with significance set at p ​< ​0.05.

RESULTS

Emerging topics over the decade included outcomes and survival, surgical innovations, and lung transplantation. There was a downward trend in research on immunosuppression, genetics, and immunology. Over the decade, the odds of women's first authorship were higher for subjects such as public health, pediatric transplantation, infectious diseases, renal transplantation, and psychological aspects. Similarly, there were lower odds for women as first authors on surgical innovations, organ preservation, living donor transplantation, liver and lung transplantation, and multiorgan transplantation. Senior women authors had higher odds of publishing on the same topics as first author, plus immunology, kidney and heart transplantation. There were lower odds that a woman would be last author of regenerative medicine and xenotransplantation. Over the decade, there were higher odds of funding for research published on xenotransplantation, regenerative medicine, and immunology. Living donor, infectious diseases, and liver transplantation had lower odds of being funded over time.

CONCLUSION

This cross-sectional study highlights the dynamic nature of transplant research, underscoring the importance of continuous observation of trends to anticipate future directions and needs in the field. The emergence of new focal areas, especially those related to technological advancements and social issues, reflects a broader trend in medical research responding to evolving challenges and opportunities. Notably, women's authorship was more prevalent in public health but less in surgical innovation. These insights can guide future research priorities, funding allocation, and clinical practices in transplantation.

Gender disparities in kidney replacement therapies and transplantation in Colombia

BACKGROUND

In chronic kidney disease (CKD), there are historical inequities in multiple stages of the pathway for organ transplantation. Women have been recognized as disadvantaged within this process even after several efforts. Therefore, we aimed to analyze the prevalence and incidence of CKD by gender and their access to Kidney replacement therapy (KRT) in Colombia.

METHODS

A cross-sectional study based on secondary analysis of national information on CKD, hypertension, diabetes, waiting list, deceased, and living donor transplantation between 2015 and 2020.

RESULTS

In Colombia, 4.934.914 patients were diagnosed with hypertension, diabetes, or CKD. 60,64% were female, with a mean age of 63.84 years (SD 14,36). Crude incidence for hypertension (10.85 vs. 7.21 /1000 inhabitants), diabetes mellitus (3.77 vs. 2.98 /1000 inhabitants), and CKD (4 vs. 2 /1000 inhabitants) was higher for females. Crude incidence for KRT was 86.45 cases /100.0000 inhabitants. In 2020, 2978 patients were on the waiting list, 44% female. There were 251 deaths on the waiting list, 38% female. This year, 517 kidney transplants were performed, and only 40% were female.

CONCLUSION

In Colombia, there are proportionally more females with CKD and precursor comorbidities. Nevertheless, there are fewer females on the waiting list and transplanted annually.