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Published on: November 7, 2020
Cardiovascular Risk Factors in Patients Before and After Successful Liver Transplantation
Damian Gojowy1, Joanna Urbaniec-Stompór1, Joanna Adamusik1
1Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland.
Insights
Cardiovascular risk factors like diabetes and hypertension significantly increase after liver transplantation (LTx). These post-transplant changes may be influenced by the original cause of liver disease, highlighting the need for careful monitoring.
Area of Science:
- Cardiology
- Hepatology
- Transplantation Medicine
Background:
- Liver transplantation (LTx) is a vital treatment for end-stage liver disease.
- Graft survival and patient outcomes are influenced by cardiovascular complications.
- Assessing cardiovascular risk factors pre- and post-LTx is crucial for patient management.
Purpose of the Study:
- To evaluate the prevalence of cardiovascular risk factors before and after liver transplantation (LTx).
- To compare the incidence of these risk factors based on the etiology of liver disease.
Main Methods:
- Retrospective review of 130 liver transplant recipients (October 2005 - April 2014).
- Assessment of cardiovascular risk factors (diabetes, hypertension, hypertriglyceridemia, hypercholesterolemia, obesity, tobacco use) at baseline and 2 years post-LTx.
- Chi-square analysis to compare risk factors based on liver disease etiology (alcohol, viral, autoimmune).
Main Results:
- Significant increases in diabetes (18% to 48%), hypertension (24% to 70%), hypertriglyceridemia (15% to 38%), and hypercholesterolemia (16% to 46%) were observed 2 years post-LTx (all P<0.001).
- Obesity prevalence increased from 13% to 18%.
- Patients with autoimmune liver disease showed lower prevalence of diabetes, hypertriglyceridemia, hypercholesterolemia, and obesity compared to those with alcoholic liver disease.
Conclusions:
- Hypertension and metabolic abnormalities (glucose, lipids) are more prevalent after liver transplantation.
- The pre-transplant etiology of liver disease may influence the post-LTx cardiovascular risk profile.
- Close monitoring and management of cardiovascular risk factors are essential in liver transplant recipients.
Abstract:
BACKGROUND Liver transplantation (LTx) is useful in the treatment of end-stage liver disease. Outcomes of transplantation are dependent upon graft survival and can also be affected by superimposed cardiovascular morbidities. The present retrospective study was performed to assess the prevalence of cardiovascular risk factors before and after LTx. MATERIAL AND METHODS A retrospective review of 130 patients undergoing liver transplantation between October 2005 and April 2014 was completed. The mean age of the patients was 49.3±11.9 years. The prevalence of cardiovascular risk factors was assessed before and 2 years after transplantation. The prevalence of cardiovascular risk factors was assessed using a comparison based upon the etiologies of liver disease resulting in transplantation including alcohol, viral, and autoimmune processes using a chi-square analysis. RESULTS The prevalence of diabetes mellitus before and 2 years after liver transplantation (LTx) were 18% and 48% (P<0.001). Hypertension was documented in 24% of patients at baseline and 70% after 2 years of follow-up (P<0.001). The prevalence rates of diabetes mellitus before and 2 years after LTx were 18% and 48% (P<0.001). The prevalence of hypertriglyceridemia before and after LTx was 15% and 38%, respectively (P<0.001). Hypercholesterolemia was noted in 16% and 46%, respectively (P<0.001). Thirteen percent of patients before LTx and 18% after were obese (body mass index higher than 30 kg/m²). The annual incidence of diabetes mellitus, hypertension, hypertriglyceridemia, hypercholesterolemia, and obesity during the first 2 years after LTx was 15%, 23.5%, 15%, 18.5%, and 6%, respectively. Twenty-four percent of patients before and 10% after LTx admitted to tobacco use (P<0.001). The prevalence of diabetes (38% vs 67%, P=0.02), hypertriglyceridemia (19% vs 63%, P<0.001), hypercholesterolemia (28% vs 67%, P=0.002), and obesity (9% vs 33%, P=0.02) was lower in patients with an autoimmune cause of liver cirrhosis in comparison to patients with alcoholic disease. CONCLUSIONS The prevalence of hypertension and glucose and lipid metabolism abnormalities may increase in patients after liver transplantation. The prevalence of cardiovascular risk factors in patients after LTx may be related to the cause of liver injury before LTx.
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