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On Waitlist for Liver Transplants, Women Die More Often Than Men

TUESDAY, Jan. 5, 2021 -- Frailty may explain why women awaiting a liver transplant are more likely than men to become too sick for a transplant or die before transplantation, a new study suggests.

Exercise and a healthier diet may help narrow that gender gap, researchers say.

For the study, researchers followed more than 1,400 patients with cirrhosis awaiting a liver transplant from nine U.S. transplant centers. About 40% were women. The men, ages 49 to 63, were more likely to have chronic hepatitis C and alcoholic liver disease.

The women, ages 50 to 63, were more likely to have non-alcoholic fatty liver disease and autoimmune cholestatic liver disease. Both groups had similar levels of disease severity.

However, the women were significantly frailer than the men, the researchers noted.

"This is the first time that frailty has been identified and quantified as a risk factor among women with cirrhosis who are waiting for liver transplants," said lead study author Dr. Jennifer Lai, a general and transplant hepatologist at the University of California, San Francisco.

"The importance of this finding is that this gender gap can potentially be mitigated through early interventions as basic as providing adequate caloric and protein intake and engaging in regular exercise. Clinicians can advise women on diet and exercise interventions that build strength," she said in a university news release.

Why women were frailer was not explored, but it is generally attributed to physical inactivity, chronic liver failure and poor diet, Lai said.

The women had a 36% greater risk of being too sick for a transplant or dying before one was available. In all, frailty accounted for 13% of the gender gap, the researchers said.

"The waitlist mortality gender gap has persisted for 15 years across the entire U.S. liver transplant system and will continue to persist if it is not recognized," Lai said. "Now that it has been recognized, it can be addressed."

The study was published Dec. 30 in JAMA Surgery.

© 2021 HealthDay. All rights reserved.

Posted: January 2021

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