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2016 ; 22
(12
): 3315-24
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Lipids in liver transplant recipients
#MMPMID27022213
Hüsing A
; Kabar I
; Schmidt HH
World J Gastroenterol
2016[Mar]; 22
(12
): 3315-24
PMID27022213
show ga
Hyperlipidemia is very common after liver transplantation and can be observed in
up to 71% of patients. The etiology of lipid disorders in these patients is
multifactorial, with different lipid profiles observed depending on the
immunosuppressive agents administered and the presence of additional risk
factors, such as obesity, diabetes mellitus and nutrition. Due to recent
improvements in survival of liver transplant recipients, the prevention of
cardiovascular events has become more important, especially as approximately 64%
of liver transplant recipients present with an increased risk of cardiovascular
events. Management of dyslipidemia and of other modifiable cardiovascular risk
factors, such as hypertension, diabetes and smoking, has therefore become
essential in these patients. Treatment of hyperlipidemia after liver
transplantation consists of life style modification, modifying the dose or type
of immunosuppressive agents and use of lipid lowering agents. At the start of
administration of lipid lowering medications, it is important to monitor
drug-drug interactions, especially between lipid lowering agents and
immunosuppressive drugs. Furthermore, as combinations of various lipid lowering
drugs can lead to severe side effects, such as myopathies and rhabdomyolysis,
these combinations should therefore be avoided. To our knowledge, there are no
current guidelines targeting the management of lipid metabolism disorders in
liver transplant recipients. This paper therefore recommends an approach of
managing lipid abnormalities occurring after liver transplantation.
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