Karnam RS, Chen S, Xu W, et al. - According to the findings of this study, women can overcome the complex problem of allocation inequity by having access to livers from living donors. Women who had only access to deceased donor liver transplant (DDLT) were significantly sicker than men who did not have liver disease at the time of listing, dropout, or liver transplant (LT). As a result, increasing the availability of living donor liver transplants would be beneficial in addressing the gender disparity in access to LT in the current MELD-Na era.

• The sample consisted of 1,289 patients (830 men and 459 women) listed for liver transplant, and the mean (SD) age was 56.1 (10.0) years at assessment and listing.

• In total, 783 of 1,289 listed patients underwent LT.

• In women receiving DDLT, those with no pLD at assessment had a higher median (range) Model for End-stage Liver Disease incorporating sodium levels (MELD-Na) score at listing and at LT.

• Women were significantly disadvantaged in the absence of a pLD; there was no difference in access to LT based on the availability of a pLD.

• Men with a pLD had a 1.39 times higher instantaneous rate of receiving a transplant than men without a pLD, and women with a pLD had a 1.92 times higher instantaneous rate of receiving a transplant than women without.

• Women had a 1.38 times higher HR than men across all MELD-Na score strata, and a 2.04 times higher HR when the MELD-Na score was less than 20.