P5881 - Sexual Health After Liver Transplantation: A Vital Aspect of Survivorship Affecting Quality of Life

Chanattha Thimphitthaya, MD¹, Alvaro Noriega Ramirez, ¹, Dyanna Gregory, MS¹, Arjmand Mufti, MD¹, Shannan Tujios, MD¹, Lisa VanWagner, MD, MSc¹, Amit G. Singal, MD, MS², Nneka Ufere, MD, MSCE³, Sarah R.. Lieber, MD, MSCR¹
1University of Texas Southwestern Medical Center, Dallas, TX; 2Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, Dallas, TX; 3Massachusetts General Hospital, Boston, MA

Introduction: Sexual health (SH) is an often-overlooked patient-reported outcome (PRO) that is vital to survivorship. To date, no studies have examined factors associated with SH post-liver transplantation (LT) or their relationship with health-related quality of life (HRQoL).

Methods: We conducted a cross-sectional study of adult LT recipients (LTRs) at least one-year post-LT, followed at a large U.S. transplant center. This study was approved by the Institutional Review Board. Participants completed an electronic survey assessing: 1) sexual activity post-LT, 2) sexual interest and satisfaction, and 3) HRQoL using validated instruments from Patient-Reported Outcomes Measurement Information System (PROMIS). Results were reported as T-scores; scores < 40 indicated low sexual interest or satisfaction. We analyzed factors associated with lower sexual satisfaction, and correlation between SH and HRQoL.

Results: Of 545 eligible LTRs, 239 completed the survey (response rate 43.9%). The cohort was 59.8% male, with a median age of 58 years (IQR 47, 67) and median post-transplant duration of 5.0 (2.9, 7.5) years. The leading LT indications were alcohol-related liver disease (34.3%), metabolic dysfunction-associated steatotic liver disease (MASLD; 19.7%), and viral hepatitis (14.7%). Most patients (77.6%) reported being sexually active post-transplant, typically resuming activity within 4–6 months, while the most frequently cited reason for sexual inactivity was lack of interest (40.8%). Sexual interest and satisfaction positively correlated with both physical and mental HRQoL scores (p < 0.01), particularly among male participants. The mean (SD) sexual interest score was 45.9 (11.9), with 32.2% reported low sexual interest. Among sexually active LTRs, mean sexual satisfaction score was 49.5 (8.3), with 11.4% experiencing low satisfaction. Although not statistically significant, patients over the age of 65, females, individuals with lower income, and those with history of alcohol use disorder tended to have higher odds of low sexual satisfaction. Interestingly, higher Charlson Comorbidity Index was significantly less associated with low sexual satisfaction (adjusted OR 0.10, 95% CI 0.02-0.58).

Discussion: Most LTRs resume sexual activity after transplantation. Sexual interest and satisfaction scores positively correlated with physical and mental HRQoL. This study highlights the importance of incorporating proactive, patient-centered SH assessment and support to enhance survivorship post-LT.


Figure: Table 1. Sociodemographic and clinical characteristics of liver transplant recipients stratified by patient-reported gender (N= 239)


Figure: Table 2. Odd ratios of factors associated with low sexual satisfaction scores after LT among sexually active LTRs

Disclosures:
Chanattha Thimphitthaya indicated no relevant financial relationships.
Alvaro Noriega Ramirez indicated no relevant financial relationships.
Dyanna Gregory indicated no relevant financial relationships.
Arjmand Mufti indicated no relevant financial relationships.
Shannan Tujios indicated no relevant financial relationships.
Lisa VanWagner: Alpha Insights – Consultant. Gerson Lehrman Group – Consultant. Madrigal Pharmaceutical – Advisory Committee/Board Member, Grant/Research Support. Slingshot Insights – Consultant. W.L. Gore & Associates – Grant/Research Support.
Amit Singal: AstraZeneca – Consultant. Bayer – Consultant. Boston Scientific – Consultant. Eisai – Consultant. Elevar – Consultant. Exact Sciences – Consultant. Exelixis – Consultant. FujiFilm Medical Sciences – Consultant. Genentech – Consultant. Glycotest – Consultant. HistoSonics – Consultant. Merck – Consultant. Sirtex – Consultant.
Nneka Ufere indicated no relevant financial relationships.
Sarah Lieber indicated no relevant financial relationships.

Chanattha Thimphitthaya, MD¹, Alvaro Noriega Ramirez, ¹, Dyanna Gregory, MS¹, Arjmand Mufti, MD¹, Shannan Tujios, MD¹, Lisa VanWagner, MD, MSc¹, Amit G. Singal, MD, MS², Nneka Ufere, MD, MSCE³, Sarah R.. Lieber, MD, MSCR¹. P5881 - Sexual Health After Liver Transplantation: A Vital Aspect of Survivorship Affecting Quality of Life, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.