Post liver transplant metabolic syndrome: Frequency, predictors and outcome

To determine frequency of post-transplant metabolic syndrome (PTMS) after liver transplantation (LT), its pre-transplant predictors and its association with cardiovascular events.

In this observational, analytical cross-sectional study done at Gastroenterology Department, Shaikh Zayed Post Graduate Medical Institute Lahore from January 2021 to March 2023, pre-transplant data of patients having LT for > 1 year including etiology of liver disease, presence of metabolic syndrome (MS), diabetes mellitus (DM), hypertension (HTN) and obesity were noted. Post-transplant evaluation was done to document DM, HTN, Dyslipidemia, obesity, PTMS and cardiovascular events after LT. Student's t test and chi square were used for correlation and linear regression for multivariate analysis.

Total of 111 post LT patients with mean age 45.2 (±10.45) and male to female ratio 6.4/1 (96/15) were included. Before LT, 15(13.5%) patients had DM, 11 (9.9%) had HTN, 48(43.2%) were obese and MS was present in 13 (11.7%) patients. Median duration since LT was three years. Post LT, PTMS developed in 60(54.1%) patients, 64(57.7%) had DM, 27(24.3%) had HTN, dyslipidemia was noted in 60(54.1%) patients and 69(62.2%) were obese. Presence of DM (OR 15.21; p< 0.001), HTN (OR 10.00; p=0.01) and MS (OR 12.50; p=0.003) before transplant was significantly associated with development of PTMS. No significant difference in development of cardiovascular events was noted in patients with and without PTMS.

Post transplant metabolic syndrome develops in majority of LT patients, risk is higher in those with diabetes mellitus, hypertension and metabolic syndrome before liver transplantation.