Abstract:
Sexual orientation and gender identity (SOGI)-diverse populations experience discrimination in organ and tissue donation and transplantation (OTDT) systems globally. We assembled a multidisciplinary group of clinical experts as well as SOGI-diverse patient and public partners and conducted a scoping review including citations on the experiences of SOGI-diverse persons in OTDT systems globally to identify and explore the inequities that exist with regards to living and deceased OTDT. Using scoping review methods, we conducted a systematic literature search of relevant electronic databases from 1970 to 2021 including a grey literature search. We identified and screened 2402 references and included 87 unique publications. Two researchers independently coded data in included publications in duplicate. We conducted a best-fit framework synthesis paired with an inductive thematic analysis to identify synthesized benefits, harms, inequities, justification of inequities, recommendations to mitigate inequities, laws and regulations, as well as knowledge and implementation gaps regarding SOGI-diverse identities in OTDT systems. We identified numerous harms and inequities for SOGI-diverse populations in OTDT systems. There were no published benefits of SOGI-diverse identities in OTDT systems. We summarized recommendations for the promotion of equity for SOGI-diverse populations and identified gaps that can serve as targets for action moving forward.
摘要:
性取向和性别认同(SOGI)-不同的人群在全球器官和组织捐赠和移植(OTDT)系统中遭受歧视。我们组建了一个多学科的临床专家小组以及SOGI多样化的患者和公共合作伙伴,并进行了范围审查,包括引用SOGI多样化人员在全球OTDT系统中的经验,以识别和探索在生活和死亡OTDT方面存在的不平等。使用范围界定审查方法,从1970年到2021年,我们对相关电子数据库进行了系统的文献检索,包括灰色文献检索。我们鉴定并筛选了2402个参考文献,包括87个独特的出版物。两名研究人员独立地对包含的出版物中的数据进行编码,一式两份。我们进行了最佳框架综合与归纳主题分析,以确定综合收益,危害,不平等,不平等的理由,减轻不平等的建议,法律法规,以及关于OTDT系统中SOGI多样化身份的知识和实施差距。我们确定了OTDT系统中SOGI多样化人群的许多危害和不平等。OTDT系统中没有公开的SOGI多样化身份的好处。我们总结了促进SOGI多样化人群公平的建议,并确定了可以作为未来行动目标的差距。