Implicit bias and the gender inequity in liver transplantation
Open accessAbstract
Women with cirrhosis awaiting liver transplantation are less likely to receive a transplant and more likely to die than men. While differences in body size and estimation of kidney function are well-studied contributors to this gender inequity, what has received relatively little mention as a potential contributing factor is the possibility of implicit bias. Implicit bias is defined as "any unconscious or unacknowledged preference that affects a person's outlook or behavior." The undeniable presence of implicit bias, a factor that is known to negatively influence health outcomes for women, within our health care system means that patients interacting within our transplant system may still experience unequal treatment despite our best efforts to modify the allocation system at the national level. Awareness of this additional source of gender-based disparities is the first step. In this article, we posit that implicit bias in liver transplantation may exacerbate the gender inequity in transplant access and provide examples in the literature to support this assertion. Lastly, we offer strategies that could be applied at the individual or the healthcare delivery system levels to help reduce the influence of implicit bias on the gender inequity in liver transplantation.
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Women with cirrhosis awaiting liver transplantation are less likely to receive a transplant and more likely to die compared to men.
“Women with cirrhosis awaiting liver transplantation are less likely to receive a transplant and more likely to die compared to men85.”
From Bias recognition and mitigation strategies in artificial intelligence healthcare applications (2025) · cites this paper as [85]
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- Authors
- Lai, J. C., Pomfret, E. A., & Verna, E. C.
- Affiliations
- University of California, San Francisco (US)
- University of Colorado Denver (US)
- Columbia University (US)
- Corresponding author
- Lai, Jennifer C.
- Pomfret, Elizabeth A.
- Venue
- American Journal of Transplantation
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 22
- Issue
- 6
- Pages
- 1515-1518
- ISSN
- 1600-6135 (ISSN-L)
- PMC
- PMC13614513
- OpenAlex
- W4210389457
- Cited by
- 30
- References
- 27
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 12 · 2022: 1
- FWCI
- 5.52
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Transplantation (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01AG059183, P30 DK026743)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- implicit bias, gender inequity, liver transplantation, access to transplantation, gender disparities in health care, organ allocation
- MeSH terms
- Bias, Implicit, Delivery of Health Care, Female, Humans, Male, Liver Transplantation, Healthcare Disparities
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