Women empowerment in the field of organ donation and transplantation - Are we there yet?
Vasanthi Ramesh1, Poorva Singh1.
1National Organ and Tissue Transplant Organisation (NOTTO), Directorate General of Health Services, Ministry of Health & Family Welfare, New Delhi, India
Introduction: Women empowerment is defined as raising the status of women through education and offering them equal opportunities as men. The empowerment of women has seen a boost in the last five decades in almost all spheres of life such as education, health and politics. Through this study, we aimed to see whether the relatively novel field of organ donation and transplantation had embraced women empowerment yet.
Materials and Methods: A PubMed search and review was done of all articles published in the last 20 years, which talk of gender related issues in the field of organ donation and transplantation. Points of comparison amongst the articles - both social and immunologic, were noted and analyzed. The national regulatory agencies for organ donation and transplantation in various countries, WHO headquarters and regional offices were also studied and a note was made of their office bearers with regard to their gender.
Results: There were approximately 100 articles which covered the topic of gender issues in organ donation and transplantation directly or indirectly. Most of these reflect the greater number of donors being women and more recipients being men in developed and developing nations alike. The possible reasons for this discrepancy were also studied – decreased access of women to healthcare compared to men and the greater predilection of women to be “givers”. This disparity has been described to be greater in living donation than deceased donation in occasional studies. The consequences of more women giving their organs to more men have been examined from an ethical as well as an immunological standpoint; there have been shown to be more rejections in female kidneys transplanted into men than male kidneys. Despite such studies, women continue to donate more organs than men to men. On the other hand, women have successfully made a mark as good administrators; many countries such as India and Spain have women as the heads of their national organ donation and transplantation regulatory agencies, who have done a commendable job in promoting organ donation and transplantation activity in these countries.
Discussion: Though gender disparity in the field of organ donation and transplantation is still widespread and universal, women have gained new ground when it comes to administration and to the successful execution of national organ donation and transplant programmes. Additionally, more and more women are taking up transplant surgery and critical care medicine as a profession and will be contributing to the field to a greater extent in the coming years in a professional capacity.
Conclusion: Women empowerment in the field of organ donation and transplantation might have come about more slowly than other aspects of healthcare but it is making its mark in a steady manner. It needs to be sustained in the administrative setup and extrapolated to the actual transplantation of organs in a medically suitable yet ethically acceptable manner.
[1] Steinman JL. Gender disparity in organ donation. Gender Medicine. 2006; 3: 246-252
[2] Lau A, West L, Tullius SG. The impact of sex on alloimmunity. Trends in Immunology. 2018; 39(5): 407-418