OBJECTIVES:Gender disparity in access to kidney transplant is a well-established universal challenge. Prior to 2020, duration on the transplant wait list was the only criterium for deceased donor kidney transplant allocation in the state of Gujarat. In January 2020, the State Organ and Tissue Transplant Organization Gujarat was formed, which implemented a point system for deceased donor kidney transplant allocation policy based on human leukocyte antigen mismatch, panel reactive antibody, and donor-specific antibody, among other factors. In this system, adult female recipients are assigned 2 additional points. We investigated the effect of change in deceased donor kidney transplant allocation policy on disparities between male and female recipients. MATERIALS AND METHODS:This is a retrospective, single-center, observational study. The number of male and female recipients who received deceased donor kidney transplant was collected from the medical records at the nephrology department for the period January 2014 through December 2024. We analyzed trends using logistic regression with inverse variance weighting. RESULTS:Over the study period, 3814 kidney transplants were conducted, comprising 2732 from living donors and 1083 from deceased donors. We found a progressive increase in the percentage of women who were deceased donor kidney transplant recipients, from 27.57% in 2019 to 50.76% in 2024 (P < .001). This increase may be attributed to the compounding effect of point allocation to the categories of donor-specific antibody, panel reactive antibody, patient age, and gender. CONCLUSIONS:Our study provided new insights for resolution of gaps in deceased donor kidney transplantation between male and female recipients. Implementation of a point-based system for deceased donor kidney transplant allocation policy with extra points for recipients who are women may increase the number of kidney transplants for these recipients. A similar policy may be undertaken by other centers to achieve a temporary solution until underlying factors leading to gender disparity are better understood and methods to overcome these challenges are formed.

Organ shortage remains a critical challenge in India's transplant landscape, despite established deceased donor organ transplantation (DDOT) programmes. Many potentially viable organs from brain-dead deceased donors (DBDs) are discarded due to uncertainties surrounding donor suitability in specific clinical scenarios. To address this gap, the Indian Society of Organ Transplantation (ISOT) convened a panel of national experts to develop a Delphi consensus statement aimed at guiding transplant professionals on the feasibility of organ donation from DBDs, particularly in complex or marginal donor situations. This position statement presents 19 consensus recommendations based on real-world clinical contexts such as extremes of age, acute kidney injury, infections (including HCV, HBV, HIV, tuberculosis, and tropical diseases), malignancy, diabetes, hypertension, and various surgical anomalies. The guidance is grounded in available literature, registry data, and extensive clinical experience, with the aim of expanding the DBD donor pool across Asia and improving access to transplantation for patients with end-stage organ failure. The consensus does not function as a formal clinical guideline but rather as a practical reference tool, acknowledging the limitations in India-specific data and the contextual differences from Western transplant settings. It encourages critical care and transplant teams to perform structured assessments of organ viability, apply ethical principles, and pursue informed consent in line with local regulations.

Swyer syndrome with complete gonadal dysgenesis is associated with an absence of testicular differentiation in a phenotypic female with a 46, XY karyotype. A 14-year-old unmarried girl was referred with complaints of primary amenorrhea and nondevelopment of breast. Her built was normal. Examination of her secondary sexual characteristics revealed no breast development, absent axillary hairs, and sparse pubic hairs. External genitalia was of female type. Karyotype showed genotype of 46, XY. Magnetic resonance imaging revealed hypoplastic uterus with absent fallopian tubes and ovaries. A diagnosis of Swyer syndrome was made. Laparoscopy showed infantile uterus, normal fallopian tubes, and streak gonads. Laparoscopic removal of streak gonads was done as there is a risk of gonadoblastoma in such cases. The patient was started on hormonal replacement therapy. Swyer syndrome results mainly due to mutation in certain genes such as SRY gene, which leads to failure of development of testis.