Sex Differences in Heart Transplantation: Evolving Trends and Insights

The purpose of this review is to provide an updated overview of recent findings and trends in heart transplantation among female patients in the United States.

Female patients continue to make up a smaller proportion of both transplant recipients and those on the waiting list and tend to experience longer wait times for transplantation. However, under the new allocation system, some positive shifts have emerged. Outcomes for female patients with ventricular assist devices have improved, and women are now being transplanted earlier than men, with more receiving a transplant within six months of listing. Additionally, offer acceptance rates for female candidates have increased. In pediatric transplantation, the proportion of female patients on the waitlist has also risen. Despite these advancements, significant challenges persist. Women continue to face lower levels of social and emotional support, higher rates of vascular complications, and reduced utilization of mechanical circulatory support.

Although women remain underrepresented in heart transplantation, emerging trends suggest improvements in certain areas, potentially due to the new allocation system. Continued efforts are needed to further address and mitigate these disparities.