The impact of solid organ transplantation on sexual dysfunction and infertility in older men and women: A Claims Based Study

Solid organ transplantation (SOT) restores organ function and prolongs survival, but its impact on sexual dysfunction and infertility is underexplored. This study evaluated changes in their prevalence before and after transplantation across organ types. We conducted a retrospective cohort study using TriNetX, including 64 932 U.S. adults (≥18 years) who underwent heart, kidney, liver, lung, or pancreas transplants within the past 20 years. Sexual dysfunction (e.g., erectile dysfunction, dyspareunia) and infertility were identified using ICD-10 codes. Pre-post analysis assessed relative and absolute risk reduction (ARR). Analyses were stratified by sex and organ type. SOT was associated with reduced sexual dysfunction (ARR 1.40%, p < 0.001) and infertility (ARR 0.10%, p = 0.013). Males experienced a greater reduction in sexual dysfunction (ARR 2.11%, p < 0.001) than females (ARR 0.20%, p = 0.035). Sexual dysfunction declined following heart (ARR 2.21%, p = 0.001), kidney (ARR 1.42%, p < 0.001), lung (ARR 1.24%, p = 0.042), and liver (ARR 0.74%, p = 0.003) transplants. No difference was seen following pancreas transplantation, and infertility prevalence did not differ across SOT types. These findings suggest SOT may improve sexual health, particularly in men, though effects on infertility remain limited.