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Is treatment of hypogonadism safe for men after a solid organ transplant? Results from a retrospective controlled cohort study

International Journal of Impotence Research volume 34, pages 50–54 (2022)Cite this article

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Abstract

Male solid organ transplant patients are at increased risk of hypogonadism and the safety of treating these patients for hypogonadism is unknown. We sought to evaluate the safety of treating hypogonadism in the solid organ transplant recipient. To accomplish this, we performed a retrospective review between 2009 and 2017 of patients treated at a single academic urology clinic. Men who underwent a solid organ transplant with a diagnosis of hypogonadism (Testosterone <350 ng/dl) were included. In total, 87 hypogonadal transplant recipients were included (29 no treatment; 58 treated). Treatment modalities included non-testosterone therapies (human chorionic gonadotropin, clomiphene), topical, injectable, and subcutaneous T preparations. There was no difference between groups for baseline characteristics including age, length of follow-up since transplant, baseline testosterone, and transplant type. There was no difference in prostate cancer diagnoses, erythrocytosis, rejection, infections, number of unplanned admissions per patient. While there was no difference in the proportion of deaths in untreated (21%; n = 6) and treated transplant recipients (7%; n = 4; p = 0.08), the median survival was longer in men treated with T (p = 0.03). Treatment of hypogonadism in solid organ recipients did not increase the risk for adverse effects related to treatment of hypogonadism or solid organ transplant.

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Fig. 1: Kaplan–Meier estimating of patient survival.

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Funding

This work is supported in part by National Institute of General Medical Sciences of the National Institutes of Health under Award Number T32GM088129, NIH grant K12 DK0083014, the Multidisciplinary K12 Urologic Research (KURe) Career Development Program (NT is a K12 Scholar). AWP is a National Institutes of Health K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the National Institute of Diabetes and Digestive and Kidney Diseases. This work is also supported in part through a Urology Care Foundation Rising Stars in Urology Award (to AWP).

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Authors and Affiliations

  1. Urology Institute, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Nannan Thirumavalavan

  2. Translational Biology and Molecular Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

    Jason M. Scovell

  3. Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

    Eric Lo, Jabez Gondokusomo, Mohit Khera & Larry I. Lipshultz

  4. Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA

    Alexander W. Pastuszak

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  1. Nannan Thirumavalavan
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Correspondence to Nannan Thirumavalavan.

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Thirumavalavan, N., Scovell, J.M., Lo, E. et al. Is treatment of hypogonadism safe for men after a solid organ transplant? Results from a retrospective controlled cohort study. Int J Impot Res 34, 50–54 (2022). https://doi.org/10.1038/s41443-020-00361-z

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