Metabolic syndrome and liver transplantation

Metabolic syndrome comprises a cluster of risk factors that predispose to mainly cardiovascular disease and its complications. It is also closely associated with liver steatosis and fibrosis. Metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease, are very prevalent both in general population and also pre- and post-transplantation setting. Important life-style changes and immunosuppressive treatment after liver transplantation seem to have significant effects for the development of the Metabolic syndrome: increased risks for liver transplant recipients and challenges for successful treatment outcomes. Its association with major vascular events and negative effects on progression of fibrosis in recurrent hepatitis C after transplantation have been major concerns for transplant patients in recent years. There is no standard therapeutic approach to these patients, and well-designed prospective studies are certainly needed to define management strategy. Until such specific data become available, early aggressive risk factor modification should be aimed and each component of the syndrome should be cared separately.