Sexual aspects of liver transplant candidates and recipients: evidence available in the literature

Abstract

Objective:to analyze the evidence available in the literature on the alterations in the sexuality of candidates and recipients of liver transplantation. Method:integrative review of the literature with search for primary studies in the databases MEDLINE (via PUBMED), CINAHL e LILACS, published in English, Portuguese and Spanish. Results:the 16 primary studies included were grouped into three categories: 1) female sexuality (n=5), 2) male sexuality (n=5) and 3) male and female sexuality (n=6). In category 1, the subjects investigated were contraception, pregnancy, sexual dysfunction, presence of gynecological symptoms and sexually transmitted infections. In category 2, the main focus of the studies was erectile dysfunction, sexual desire and satisfaction, and consequences of the immunosuppressive regimen with mycophenolic acid in men. In category 3, the evaluation of sexual function was the main topic. Conclusion:the scientific evidence generated provides support to encourage health professionals to incorporate the topic of sexuality in the routine of care. Knowledge gaps were identified and new studies should be conducted in order to implement interventions to prevent, minimize and/or control changes related to the patient’s sexuality.

Quality of Life and Liver Transplant: A Comparative Evaluation between Different Post-transplant Phases

“…27 It is known that satisfactory sexual health is fundamental for quality of life in transplanted patients; therefore, it cannot be disregarded during outpatient monitoring. 11 The improvement in the sleep pattern observed in this study can be related to reduction of the anxiety related to the disease and the expectation of undergoing the transplant, as well as the resolution of physiological conditions present in the disease in the initial post-transplant phase.…”

“…End-stage liver disease significantly reduces the patients' quality of life. 11 However, when liver transplant becomes the only option for chronic liver patients, although complex and expensive, it tends to enable physical, and psychological improvement in the patients. After transplantation, the patient needs to be monitored by a specialised multiprofessional team and to use of immunosuppressive medications throughout life, where their benefits outweigh the risks, and harms.…”

Contexto social do adolescente na condição de ser transplantado renal

“…Evidencia-se que a função sexual é sensível à doença, ao sofrimento psicológico e ao desequilíbrio das relações interpessoais. Na maioria dos casos, a doença crônica é associada com a disfunção sexual, resultando na diminuição da atividade sexual em decorrência do mal-estar, da fadiga e de mudanças na imagem corporal (16) .…”

Promoting safe sexual practices and sexual health maintenance in pediatric and young adult solid organ transplant recipients

“…63% of this group requested more face‐to‐face guidance on the subject 2 . Similarly, adult kidney and liver transplant recipients also report high rates of sexual health concerns with ill‐preparation from their transplant providers 3‐8 …”

“…2 Similarly, adult kidney and liver transplant recipients also report high rates of sexual health concerns with ill-preparation from their transplant providers. [3][4][5][6][7][8] Transplant practitioners also report feeling underequipped to discuss aspects of sexual health reaching beyond teratogenicity of staple immunosuppressants. In a survey of 69 pediatric renal transplant nephrologists, Ashoor et al found that 67% felt comfortable counseling on safer sex, but less than half regularly discussed contraceptive options, unintended pregnancy, or provided specialist referrals for contraception.…”