Sorrell James H, Brown Jill R
Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE 68132, USA.
Liver Transpl. 2006 Oct;12(10):1473-7. doi: 10.1002/lt.20812.
The effects of end-stage liver disease (ESLD) on sexual functioning are complex and often overlooked in the context of chronic illness and the transplantation evaluation. The aim of the present study is to report on the prevalence of sexual dysfunction in patients with ESLD presenting for liver transplantation evaluation, as well as to examine a cohort after transplantation. Participants included 173 consecutive adult outpatients with ESLD who presented for orthotopic liver transplantation evaluation. All transplant candidates underwent a psychiatric evaluation, and a sexual history was taken by the transplant psychiatrist. Patients who received a liver transplant were contacted by telephone for follow-up (n = 39). The following domains were explored: sexual frequency, satisfaction, ability to orgasm, sexual interest, and, for men, erectile dysfunction. Before transplantation, high levels of sexual dysfunction were found, with women showing higher levels of dysfunction than men. Increased age and more severe liver disease were related to lower sexual frequency and satisfaction. Contrary to previous work, the cause of disease (alcoholic liver disease) was not related to sexual functioning before transplantation. Those with erectile dysfunction before transplantation showed continued dysfunction after transplantation. An additional finding was an age and gender bias against taking a sexual history from older women. Overall, for both men and women, the findings point to continued and persistent sexual dysfunction after transplantation. Findings may help transplant teams routinely inquire into the sensitive domain of sexual functioning early on and thereby provide an opportunity for treatment. Liver Transpl 12:1473-1477, 2006. (c) 2006 AASLD.
终末期肝病（ESLD）对性功能的影响较为复杂，在慢性病及移植评估背景下常被忽视。本研究旨在报告接受肝移植评估的ESLD患者性功能障碍的患病率，并对移植后的一组患者进行检查。研究对象包括173例连续的成年ESLD门诊患者，他们前来接受原位肝移植评估。所有移植候选人都接受了精神科评估，移植精神科医生采集了性史。对接受肝移植的患者通过电话进行随访（n = 39）。探讨了以下几个方面：性频率、满意度、性高潮能力、性兴趣，对于男性还包括勃起功能障碍。移植前，发现性功能障碍水平较高，女性的功能障碍水平高于男性。年龄增加和肝病更严重与性频率和满意度降低有关。与之前的研究不同，疾病病因（酒精性肝病）与移植前的性功能无关。移植前有勃起功能障碍的患者移植后仍存在功能障碍。另一个发现是在采集老年女性性史方面存在年龄和性别偏见。总体而言，对于男性和女性，研究结果都表明移植后性功能障碍持续存在。这些发现可能有助于移植团队尽早常规询问性功能这一敏感领域，从而提供治疗机会。《肝脏移植》12:1473 - 1477，2006年。（c）2006年美国肝脏病研究协会。
