Women less likely to receive DCD heart transplants
The use of donation after circulatory death (DCD) donors for heart transplants (HT) has started growing more and more common in the United States. This is seen as an effective way to expand the donor pool for patients with advanced heart failure.
However, according to a new analysis published in Circulation: Heart Failure, men are more likely than men to be listed for a DCD HT.[1]
“Contemporary methods to increase the standard donor pool include the use of donors who are infected with the hepatitis C virus and DCD donors,” wrote first author Ersilia M. DeFilippis, MD, a cardiologist with Columbia University Irving Medical Center, and colleagues. “DCD HT has shown promising early outcomes, yet data are lacking on whether DCD donors are being utilized equitably for all populations.”
DeFilippis et al. tracked data from the Organ Procurement and Transplantation Network, focusing on nearly 10,000 HT candidates listed for the first time from 2019 to 2023. Only HT candidates listed at centers with experience performing a DCD HT were included.
Overall, after adjusting for certain variables, the group found that women were less likely than men to be listed for a DCD HT and only accounted for approximately 20% of all DCD HTs.
During the same time period, women made up nearly 28% of donation after brain death HTs.
The group also emphasized that patients listed for a DCD HT were linked to an increased likelihood of receiving a new heart—a trend that was observed for both men and women. Meanwhile, the survival rate one year after a DCD HT was similar for the two sexes, further establishing that these procedures are just as beneficial for women as they are for men.
“Our analysis showed that women were less likely to be listed for DCD HT after multivariable adjustment, which inherently puts women at a disadvantage for receiving a DCD heart,” the authors wrote. “The process of undergoing a DCD HT is complex and involves center-level experience, patient education by the transplant team, patient consent to DCD HT and acceptance of a DCD donor by the transplant team.”
Another key takeaway from the group’s research was the fact that women undergoing a DCD HT were more likely to be white and have a higher level of education.
“The reasons for these differences will need to be explored with future analyses that can identify where these biases are occurring within the donor selection process,” the authors wrote. “Given sex differences in post-HT morbidity, longer-term follow-up is needed to evaluate sex differences in clinical outcomes and mortality after DCD HT.”
Looking ahead, the authors called for new approaches “at the provider, institutional and national levels” to help ensure more women receive the life-saving care they need.
Click here to read the full analysis.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.