Cardiovascular risk factors after liver transplantation

✍ Scribed by Santiago J. Muñoz; Hisham ElGenaidi

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 72 KB
• Volume: 11
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20602

✦ Synopsis

Key

Points 1. Yearly screening of liver recipients with serum cholesterol, triglycerides, and lipoproteins, and assessment for risk factors for atherosclerotic cardiovascular disease, is an important component of comprehensive post transplant care. 2. Revised guidelines and target levels of LDL-cholesterol levels specific for moderate and high cardiovascular risk patients have been recently revised. 3. Transplant physicians should be aware of advances in the management of post transplant arterial hypertension, diabetes mellitus, obesity, and nicotine dependence. (Liver Transpl 2005;11:S52-S56.)

Background

T he longer survival of liver transplant (LTx) recipi- ents achieved over the last decade has placed renewed emphasis on the management of metabolic complications which generally develop several years after the transplant procedure. The main threats to the liver allograft currently are those associated with recurrence of the original liver disease, particularly hepatitis C virus infection. However, metabolic complications such as diabetes mellitus, dyslipidemia, obesity, arterial hypertension, and renal disease have an increasing importance in the late posttransplant years. [1][2][3][4][5][6] The chronic adverse effects of therapeutic drugs required for immunosuppresion, evolving lifestyles, pre-existing disorders, and genetic susceptibility all interact in a complex fashion in LTx recipients and ultimately often lead to a relatively high profile of risk for atherosclerotic cardiovascular disease (ASCVD). Unfortunately, even in the non-transplant setting, there is considerable physician unawareness and lack of adherence to guidelines for prevention of cardiovascular disease.