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2016 ; 22
(28
): 6416-23
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Metabolic complications in liver transplant recipients
#MMPMID27605877
Jiménez-Pérez M
; González-Grande R
; Omonte Guzmán E
; Amo Trillo V
; Rodrigo López JM
World J Gastroenterol
2016[Jul]; 22
(28
): 6416-23
PMID27605877
show ga
The metabolic syndrome (MS), which includes obesity, dyslipidaemia, hypertension
and hyperglycaemia according to the most widely accepted definitions now used, is
one of the most common post-transplant complications, with a prevalence of
44%-58%. The MS, together with the immunosuppression, is considered the main risk
factor for the development of cardiovascular disease (CVD) in transplant
recipients, which in turn accounts for 19%-42% of all deaths unrelated to the
graft. The presence of MS represents a relative risk for the development of CVD
and death of 1.78. On the other hand, non-alcoholic fatty liver disease (NAFLD),
considered as the manifestation of the MS in the liver, is now the second leading
reason for liver transplantation in the United States after hepatitis C and
alcohol. NAFLD has a high rate of recurrence in the liver graft and a direct
relation with the worsening of other metabolic disorders, such as insulin
resistance or diabetes mellitus. Consequently, it is vitally important to
identify and treat as soon as possible such modifiable factors as hypertension,
overweight, hyperlipidaemia or diabetes in transplanted patients to thus minimise
the impact on patient survival. Additionally, steroid-free regimens are favoured,
with minimal immunosuppression to limit the possible effects on the development
of the MS.
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