(371) Testosterone Levels after Lung Transplant: An Analysis of the TriNetX Research Network

Abstract

Abstract Introduction Men with end stage organ dysfunction or failure are more likely to have low testosterone. In the case of men with heart and kidney failure, improvement in testosterone levels are seen after successful transplantation. Limited data exists regarding the natural course of serum testosterone after lung transplant. Objective To report incidence of low testosterone in men prior to lung transplant and to determine changes in testosterone levels after transplantation. Methods We compiled all clinical data from the TriNetX research network, a globally federated health research network (with waiver from Western IRB) that provides de-identified clinical information from 58 heath care organizations, and over 80 million patients located within the United States. We selected male patients (aged ≥ 18) with a history of lung transplant and testosterone levels recorded before and after transplantation. All men who had a recorded prescription for testosterone therapy were excluded. For all patients, we collected clinical information including demographics, comorbidities, laboratory findings, and medication use. Patients were stratified by testosterone levels and grouped into those who had low serum testosterone versus those with normal levels, with a cut-off point of 300 ng/dL. Patient characteristics were compared using descriptive statistics. Propensity score matching was performed between the two groups to normalize differences in pre-operative characteristics. Mean serum testosterone levels before and after transplantation was compared using a paired T test to determine change in serum testosterone levels after successful transplantation. Results A total of 37 men were identified with history of lung transplant, and testosterone levels recorded before and after transplant. Average serum testosterone level in the year prior to lung transplantation was 301.57 +/− 163.25. After transplantation, average serum testosterone was 332.37 +/− 200.92, for a mean difference of 30.80 (p = 0.4815). Prior to transplantation, 24 (65%) men met criteria for low serum testosterone. After transplantation 17 (46%) men demonstrated serum testosterone less than 300 ng/dl. Among men with low serum testosterone, average testosterone levels in the year prior to lung transplantation was 203.29 +/− 66.57, and was 332.37 +/− 200.92 after transplantation (p = 0.0057). Conclusions Among men with low serum testosterone receiving lung transplant, transplantation was associated with rescue of low testosterone levels. Further research incorporating a larger cohort is required to determine which patients recover endocrine function after lung transplant and whether etiology of chronic lung disease results in different outcomes after transplantation with regards to serum androgen level and function. Disclosure No