Effect of Liver Transplantation on the Hypothalamic‐Pituitary‐Gonadal Axis of Chronic Alcoholic Men with Advanced Liver Disease

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Abstract
The hormones testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH) were assayed in blood obtained from men with alcoholic liver disease before and after successful liver transplantation. The frequency and severity of self reported impotence, intercourse, and paternity were assessed before and 18 ± 3 months post‐transplantation. The results obtained were compared with those of age‐matched males transplanted within the same month by the same surgical teams for advanced hepatocellular disease other than alcoholism. Little change for any parameter assessed pre‐ and post‐transplantation was noted for the nonalcoholics. In contrast, the FSH, LH, and testosterone levels of the alcoholic men all increased significantly following successful transplantation. These data suggest that the liver disease associated with alcoholism contributes to some of the endocrine effects of alcohol‐associated cirrhosis but not all. Because the transplanted alcoholics remain less adequate than controls, it is further suggested that some residual alcohol‐induced injury to the hypothalamic‐pituitary‐gonadal axis persists despite successful liver transplantation.