Donor education pre-transplant may help improve recovery, reduce concerns

A new study found that sexual function in adult living donors was lower at the evaluation phase and at three months following liver transplantation. Results published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, suggest that donor education prior to surgery may improve recovery and ease concerns about sexual function following the transplant.

Living liver donors provide a healthy portion of their liver to an individual with end-stage liver disease. These donors make a personal sacrifice to help save another individual from certain death. Much of the medical literature focuses on the health-related quality of life of donors, but limited evidence is available regarding sexual function. A prior single-center study found that nearly 50% of donors reported a worsening of sexual function one week to one month following donation, returning to normal at three months post-operation.

"To further knowledge in this important area, our study sought to identify the extent of sexual concerns for liver donors," said lead author Dr. Andrea DiMartini with Western Psychiatric Institute and Clinic in Pittsburgh, Pa. "Our investigation examined sexual functioning of liver donors before and after donation using data from a multi-site investigation, known as the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL).

For this study the team examined the sexual function of 208 liver donors and any changes that may occur during the first year following donation using self-reported surveys. A group of 155 non-donors also completed the survey that included questions regarding sexual desire, satisfaction, orgasm, and erectile function in men.

Analyses show that donor sexual performance was lower at the time of evaluation and three months after transplant surgery than at one year following donation. Researchers found that during the early recovery phase, abdominal pain was linked to difficulty reaching orgasm; concerns over appearance was associated with lower sexual desire; and not feeling back to normal correlated to a dissatisfaction with sexual life.

Dr. DiMartini concludes, "The goal of all donor teams is to create a positive experience, both mentally and physically, and reduce stress for organ donors. Our findings suggest that providing more information to donors about what to expect with sexual function will help ease concerns and prepare themselves for the early days following liver transplant surgery."