Gender issues in transplantation.

The effects of gender mismatch in clinical transplantation have been recognized for half a century. But gender issues in clinical transplantation affect outcomes at many levels beyond immunologic concerns. Many diseases leading to transplantation are predominantly expressed in one gender. Organ donation patterns have consistently been defined by a greater tendency of women to be live donors. Access to transplantation may be affected by subtleties in the interactions of transplant personnel with women versus men candidates. In the new field of stem-cell transplantation, functional differences in male versus female adult stem cells may shed light on gender differences in outcomes for solid organ transplantation. This review highlights gender issues related to transplantation with a goal of optimizing the care of all transplant patients.