AUTHOR=Vinson A. J. , Ahmed S. B. 

TITLE=Representation of Women in Contemporary Kidney Transplant Trials

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11206

DOI=10.3389/ti.2023.11206

ISSN=1432-2277

ABSTRACT=Women are underrepresented in many clinical trials, however representation of women in kidney transplant (KT) trials may be better than for other medical disciplines. Whether the intervention or trial focus in KT patients influences this is unknown.

The weighted participation-to-prevalence ratio (PPR) for women enrollees in KT trials was determined for 5 leading medical transplant or kidney journals between 2018 and 2023 using meta-regression overall and in three sensitivity analyses by:
i.	Whether the intervention examined immunosuppression.
ii.	Area of trial focus.
iii.	Medical/surgical versus social/behavioral interventions.

Overall, 33.7% of participants in 24 trials were women. The overall pooled PPR for the included trials was 0.80, 95% confidence interval (CI) 0.76-0.85, with significant heterogeneity between trials (I2 56.6%, p-value < 0.001). Women had a lower PPR when the trial involved immunosuppression (PPR 0.77, 95% CI 0.72-0.82) than when it didn’t (PPR 0.86, 95% CI 0.80-0.94). Women were less likely to participate in trials with a medical/surgical versus behavioral intervention; the lowest PPR for women was in studies examining rejection risk (PPR 0.75, 95% CI 0.70-0.81).

There is reasonable overall representation of women in KT trials, however women remain underrepresented in transplant trials examining immunosuppression or transplant rejection risk.