{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:59:37Z","timestamp":1790132377563,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2025\/GNT2041699"],"award-info":[{"award-number":["2025\/GNT2041699"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While sex disparities in access to transplant have been shown in a number of countries, the ways additional measures of disadvantage, such as intersectional and clinical disadvantage, influence sex\u2010based disparities is less well understood. Access to transplant by sex or intersectional disadvantage has not been studied in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population\u2010based cohort study of incident dialysis patients (2006\u20132023) using Australia &amp; New Zealand Dialysis and Transplant Registry data. Cox proportional hazards models, interaction analyses and competing\u2010risk approaches were used to evaluate associations between sex, waitlisting and deceased donor transplantation, adjusting for intersectional and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 47\u2009884 incident dialysis patients contributing 147\u2009510 person\u2010years of follow\u2010up, females were 19% less likely to be waitlisted than males (aHR 0.81, 95% CI 0.77\u20130.84). Sex\u2010based disparities were greatest among females with intersectional disadvantage, including ethnic minority status (Aboriginal &amp; Torres Strait Islander: aHR 0.57, 95% CI 0.49\u20130.66), diabetic kidney disease (aHR 0.61, 95% CI 0.56\u20130.67), having \u2265\u20093 comorbidities (aHR 0.66, 95% CI 0.56\u20130.79) and obesity (aHR 0.69, 95% CI 0.65\u20130.75), compared to male peers. Once waitlisted, females and males had similar likelihood of deceased donor transplantation (aHR 1.04, 95% CI 0.99\u20131.10) and comparable waitlist mortality (aHR 0.91, 95% CI 0.76\u20131.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Females in Australia experience substantially reduced access to the kidney transplant waitlist, with the greatest inequities affecting those facing overlapping social and\/or clinical disadvantage. The absence of sex\u2010disparity after waitlisting indicates that inequities arise earlier in the referral and evaluation pathway. Interventions to improve equity must target these upstream stages and address intersecting drivers of disadvantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70276","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:15:32Z","timestamp":1788491732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex and Intersectional Disparities in Access to Deceased Donor Kidney Transplantation: A 17\u2010Year Population\u2010Based Cohort Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8415-0492","authenticated-orcid":false,"given":"Tennille L.","family":"Vitagliano","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Allergy and Immunology and the Kids Research Institute The Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7739-3656","authenticated-orcid":false,"given":"Nicole L.","family":"De La Mata","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-073X","authenticated-orcid":false,"given":"Peter S.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Allergy and Immunology and the Kids Research Institute The Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen I.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Centre for Kidney Research, Kids Research Institute and the Department of Nephrology The Children's Hospital at Westmead  Westmead New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wyburn","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Renal Medicine Royal Prince Alfred Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9250-107X","authenticated-orcid":false,"given":"Melanie L. 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