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Introduction: Current research in the areas of liver transplant and cognitive function has primarily examined cognitive changes from pre- to 1-year posttransplant, resulting in an insufficient understanding of cognitive trajectory beyond early periods of transplant and its impact on self-management. This study aimed (1) to describe global and domain-specific cognitive function in liver transplant recipients who survived more than 6 months after transplant and (2) to describe patient and clinical characteristics of recipients with impaired global and/or domain-specific cognitive function. Further, this study explored the potential relationships between cognitive function and self-management by examining differences in cognitive function by levels of self-management. Design: This secondary data analysis included 107 adult liver transplant recipients, who had a functioning transplant for at least 6 months. Data of cognitive function, demographic and clinical characteristics, and self-management were extracted for this study. T tests, Mann-Whitney tests, and Kruskal-Wallis tests were used to examine differences in cognitive function by variables. Results: More than half of the recipients had global cognitive impairment. Significant differences were found in global and domain-specific cognitive function. Older, male, married, or deceased donor recipients had lower cognitive test scores than younger, female, single, or living donor recipients. There were no significant differences in global and domain-specific cognitive function by time since transplant and levels of self-management. Discussion: Future longitudinal studies should examine the long-term trajectory of cognitive function posttransplant. Other factors such as caregivers’ participation in self-management should be accounted for in future studies when examining the relationship between cognitive function and self-management.

Self-management studies in liver recipients have been narrowly focused on medication nonadherence and alcohol recidivism. To improve self-management in recipients, self-management beyond medication nonadherence and alcohol recidivism should be comprehensively examined.

Context-Chronic illnesses such as kidney failure and diabetes and their treatments can affect people's identity, including their sexual identity. Little is known about patients' perspective on the effect of transplant on their sexual identity. Objective-To explore the sexual concerns of kidney and simultaneous pancreas/kidney transplant recipients. Design-Descriptive, qualitative. Setting-Major Midwestern university hospital. Patients-143 kidney and 70 pancreas/kidney transplant recipients; most were male (63.0%), married (64.7%), and white (83.7%), and the mean age was 49 years. Intervention-The qualitative data reported in this manuscript are derived from 2 larger quantitative studies of sexuality and quality of life in kidney and pancreas/kidney transplant recipients. The questionnaire in those studies included 2 open-ended questions that allowed participants to share their experiences as transplant recipients. Main Outcome Measure-Two faculty and 3 students did a conventional content analysis on patients' responses to the open-ended questions. Codes were extracted from the responses and then themes were created that best represented the codes. Results-Participants shared how sexual concerns affected their identity as sexual beings after transplant. Based on the responses to these open-ended questions, 4 themes were identified: sexual functioning, health care concerns, relationship with partner, and appearance changes. The study results indicate the need for improved education and provider-initiated dialogue related to sexuality after transplant.

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