Graciela E. Castro-Narro, Departamento de Gastroenterología, Servicio de Hepatología y Trasplante Hepático, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Unidad de Hepatología y Trasplante, Hospital Médica Sur; Ciudad de México, México
Juanita Pérez-Escobar, Servicio de Trasplantes, Hospital Juárez de México, Ciudad de México, México
Eira Cerda-Reyes, Departamento de Investigación, Hospital Central Militar, Ciudad de México, México
Access to liver transplantation among women remains limited due to biological and sociocultural factors. Differences in height, muscle mass, and renal function estimation significantly affect prioritization, particularly under the classic Model for End-Stage Liver Disease (MELD). Although the implementation of MELD 3.0 has reduced some disparities, structural biases persist, especially regarding exception points and graft size compatibility. Newer models such as MELD-GRAIL-Na and GEMA-Na, along with surgical strategies like split-liver and pediatric donation, offer promising alternatives. The objective of the present review is to summarize recent evidence and propose targeted measures to achieve greater gender equity in liver transplantation allocation.
Keywords: Liver transplant. Women. Access. MELD. Disparity.