Solid organ transplant linked to reduced sexual dysfunction in patients

Credit: Unsplash / National Cancer Institute

Solid organ transplant is linked to significantly reduced risk of sexual dysfunction, according to new findings that highlight a lesser understood outcome of longevity-promoting procedures.

New data presented at the Sexual Medicine Society of North America (SMSNA) 2024 Fall Scientific Meeting in Scottsdale, AZ this week showed sexual health was significantly improved in solid organ transplant recipients—a population who were in plurality middle-aged, with chronic conditions including hypertension, diabetes and depression. The research additionally showed a smaller benefit in fertility among the same population post-transplant, although the outcome was not statistically significant.

Investigators from Houston Methodist Hospital conducted a large, retrospective cohort analysis to assess outcomes of sexual function and fertility in a real-world population of patients to receive solid organ transplant. The prospect of improved sexual function for this population is particularly interesting given the sheer amount of patients it would impact: more than 46,000 solid organ transplants were performed in in the US 2023, a record high total that surpassed the approximate 43,000 the year prior.

“While much research has focused on fertility outcomes, the impact of transplantation on sexual function in both male and female recipients remains underexplored, revealing a critical gap in understanding long-term post-transplant quality of life,” investigators wrote. “Addressing sexual dysfunction and fertility concerns is vital to improving the holistic care of transplant recipients and enhancing both their physical and emotional well-being.”

The team’s cohort analysis included data from heart, kidney, liver, lung and pancreas transplants available in the TriNetX United States Collaborative Network, conducted in the last 20 years. They collected patient demographics, comorbidities, laboratory data and medications; sexual dysfunction composite data and infertility composite data were informed by diagnostic codes.

Sexual dysfunction outcomes included erectile dysfunction, vaginismus, dyspareunia, and similar conditions. Fertility outcomes were assessed for both male and female transplant recipients. Investigators additionally performed a subgroup analysis to compare outcomes between male and female recipients.

The final analysis included 68,620 solid organ transplant recipients from 50 transplant centers. Mean patient age at the time of the procedure was 58.7 years old; mean follow-up was 6 years. A majority of patients were male (62%) and White (60%).

The most common comorbidities among transplant recipients included essential hypertension (69.0%), diabetes mellitus (45.0%), chronic ischemic heart disease (33.0%), overweight / obesity (27.0%), and depressive episodes (17.0%). Only 2.0% of patients reported tobacco use. The most common immunosuppressants used in transplant recipients included methylprednisolone, mycophenolate mofetil, and tacrolimus.

In total, investigators observed composite sexual dysfunction in 5521 patients post-transplant (8.2%); among them, 2891 (12.2%) were male and 409 (1.7%).

Solid organ transplant was associated with a 17% reduced risk of sexual dysfunction in all patients (hazard ratio [HR], 0.83; 95% CI, 0.80 – 0.86; P <.001). The risk reduction was more significant for male patients (HR, 0.83; 95% CI, 0.79 – 0.88; P <.001) than it was for female patients (HR, 0.88; 95% CI, 0.77 – 1.02; P = .088).

The team further observed 236 composite infertility cases post-transplant (0.004%). It was slightly more common among female patients (n = 96 [40%]) than male patients (n = 82 [0.34%]). Solid organ transplant was associated with a 14% overall reduced risk of infertility among recipients, though the finding was statistically insignificant (HR, 0.86; 95% CI, 0.71 – 1.04; P = .12).

Investigators concluded their findings “emphasize the importance of considering sexual health” in post-organ transplant care, with an apparent opportunity to further explore the effect of major procedures on sexual health and fertility in patients.

“There is a great need for further research into long-term sexual health and reproductive outcomes of transplant recipients, ultimately improving patient care and quality of life,” they wrote.

References

Thompson L, Yatsenko T, Riveros C, Muthigi A. Solid Organ Transplantation Improves Sexual Dysfunction in Older Men and Women. Paper presented at: Sexual Medicine Society of North America (SMSNA) 2024 Fall Scientific Meeting. Scottsdale, AZ. October 17 – 21, 2024.

U.S. Department of Health & Human Services. Organ donation statistics. OrganDonor.gov. Accessed October 21, 2024. https://www.organdonor.gov/learn/organ-donation-statistics

United Network for Organ Sharing. 2022 organ transplants again set annual records. Published December 2022. Accessed October 21, 2024. https://unos.org/news/2022-organ-transplants-again-set-annual-records/