S2856 Sexual Health After Liver Transplantation: A Vital Aspect of Survivorship Affecting Quality of Life

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 1-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% man, 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 man 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, women, 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). Conclusion: 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.