Why girls are less likely to be put on transplant waiting lists than boys

Academics have discovered that some children need a kidney transplant are faced with inequalities under their custody.

The researchers have decided to examine whether inequalities exist in access to kidney transplantation in children UNITED KINGDOM By analyzing the UNITED KINGDOM Renal register and NHS Blood and Transplant Data between 1996 and 2020.

The team of University of Bristol found that black children were less likely to be placed on the transplantation waiting list, as well as those from more disadvantaged backgrounds.

Girls were also 12% less likely to be placed on a transplantation waiting list compared to boys.

There are currently 137 children aged 17 and under on the renal transplant waiting list in the United Kingdom.

Dr. Alice James, principal author of the study, said that gender disparity in the waiting list can reflect “implicit gender biases in clinical decision -making, differences in parental advocacy or variation in the presentation of the disease and the seriousness between the sexes.”

“There may also be social factors that influence clinicians’ hypotheses on the ability of transplantation or family engagement in the transplantation process,” she said.

“Although evidence is limited in pediatric populations, adult studies suggest that women are often perceived as less appropriate candidates due to comorbidities or psychosocial factors – perceptions that can expand inadvertently to children.”

He also found that children from the poorest history were 33% less likely to be on the waiting list compared to those of the richest, and black children were 19% less likely to be put on the waiting list compared to their white peers.

Once children are on the waiting list, gender and income disparities seemed to reduce, however, the disadvantages for black children have persisted.

“We were particularly struck by the way these disparities appear early in the process of transplantation,” said Dr. James.

“It is not only a question of knowing who obtains a transplant, but who is even considered in the first place.

“Those of black ethnic history are faced with systemic drawbacks even after being placed on the waiting list, including fewer opportunities for living donors.”

By looking at the renal transplants given by a donor living within two years of the waiting list, the chances of obtaining a transplant are lower among those from poorer backgrounds and children of black or Asian ethnicity, according to the study, which was presented at the ESOT (European Society for Organ Transplantation) Congress 2025.

Dr. James added: “It is notable – and particularly worrying – that such disparities are obvious even in a pediatric population within a universal health system like the NHS.

“Persistent disadvantage in the face of children from black ethnic backgrounds even after the waiting list is particularly striking, suggesting systemic or cultural barriers that extend beyond access.”

Fiona Loud, director of politicians at Kidney Care UK, said research was “shocking”.

“You have to do more work to explore local obstacles and raise awareness of the value and importance of living kidney donation thanks to personalized and community education programs.”

Professor Derek Manas, medical director for the donation of organs and tissues to NHS Blood and TransplantWho is responsible for the allocation of organs to people on the list, said: “These results will help the hospital clinical teams across the United Kingdom to better understand and mitigate this problem.

“Blood and transplantation of the NHS do not decide which individual patients are added to the transplantation waiting list, but we manage how the organs are allocated to patients, and research revealed that once patients are on the waiting list, they had equitable access to donations, regardless of ethnic or deprivation.

“The transplant community has traveled a long way to guarantee equity once listed, but this study confirms that we all have more to do.

“The kidneys must also be equaled and people of the same ethnic group are more likely to be a match.

“There are currently not enough donors from black and Asian and we urge people to show their support for the donor Donor Donor Register and to tell their families that they want to make a donation.”