According to ERJ Open Research research, women are less likely to receive a lung transplant and spend an average of six weeks longer on the waiting list. Women who undergo a lung transplant, on the other hand, are more likely than men to survive five years after the procedure. Based on these findings, researchers are advocating for legislative and clinical guideline modifications to address this disparity. Lung transplantation is the sole therapy option for those with end-stage respiratory failure, and those on the waiting list are at significant risk of death. A transplant restores normal lung function, giving patients a longer life expectancy and a higher quality of life. 

Dr. Adrien Tissot, the lead researcher from Nantes University Hospital in France, remarked, "It is crucial to remember that persons on the transplant waiting list have a minimal quality of life; they are sometimes unable to leave their home and are at high danger of mortality. Waiting is painful for many individuals, and the longer they have to wait, the worse their condition becomes."

The study consisted of 1,710 participants—802 women and 908 men—who received treatment at one of France's 12 transplantation centres between 2009 and 2018. Following transplantation, we observed the patients for approximately six years. The patients' principal underlying disorders were chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease. This is the first study to look at all three stages of the transplantation procedure in the same patient group: the pre-transplant waiting time, transplantation surgery and immediate aftermath, and post-transplant survival across months and years. 

According to available data, women wait an average of 115 days for a lung transplant, whereas males wait only 73 days. Women were also less likely to have a transplant, with 91.6% undergoing surgery compared to 95.6% for men. Previous studies have found that women are more likely to die while awaiting a transplant. Despite these hurdles, women had higher post-transplant survival rates, with 70% of female recipients still alive five years later vs. 61% of male recipients. 

Donor-recipient size matching is a substantial contributor to the difference. The majority of women received donor lungs that matched their sex and height. Male donors account for 56% of total donors, and men are 13 cm taller than women; hence female patients must wait longer for an eligible donor. However, the study discovered that women who received an 'oversized' lung did not have lower survival rates, implying that expanding size-matching criteria could help resolve gender disparities in lung transplantation. 

Dr. Tissot emphasised that "clinicians, patients, and policymakers must acknowledge this gender difference in order to take appropriate action." Early listing for women or changing the allocation policy of donor lungs to recipients could be considered. We believe our findings, such as the possible importance of size matching and its impact on access to lung transplantation and length of time on the waiting list, may be applicable in other countries where lung transplantation is conducted." 

Dr. Michael Perch, Chair of the European Respiratory Society's Group on Lung Transplantation and a senior consultant at Rigshospitalet in Copenhagen, Denmark, who was not involved in the study, stated, "Understanding gender disparities in transplantation is a critical first step towards improving patient care for women and reducing the time they spend on the waiting list." There could be various reasons why women wait an average of six weeks longer than males, including variations in education and health literacy, socioeconomic status, immunological variables, and donor-recipient size matching. 

Dr. Perch went on to question current transplantation practices, stating, "Clinicians and policymakers alike must question why there is a focus on gender and size matching in transplantation when evidence shows that, in lungs, these factors do not determine a woman's chance of survival, and it ultimately risks an increase in women dying while waiting for a transplant." Women should not have to wait longer than men for these life-saving contributions, and we must implement meaningful corrective measures." 

This study emphasises the critical need to address gender inequities in lung transplantation, as well as in many other aspects of healthcare. As female lung transplant recipients' survival rates exceed those of males, the longer wait times and lower likelihood of transplantation for women raise questions about the fairness of present medical standards. Experts emphasise the significance of reassessing donor-recipient matching criteria and pushing for regulatory changes that enable equal access to life-saving treatments for all patients, regardless of gender.