Common medical diseases after liver transplantation

Liver transplantation is now routinely used as a definitive treatment for patients with advanced cirrhosis. As survival after transplantation in most centers is at or above 70% to 80% at 1 year, an increasing number of liver transplant recipients requires further medical care. Several medical complications may develop during the immediate or long-term postoperative periods, including renal dysfunction, arterial hypertension, neurological complications, and psychiatric complications. In addition, other metabolic complications often develop in a more insidious manner, such as obesity, hyperlipidemia, diabetes mellitus, and posttransplant bone disease. Because the liver allograft function is frequently normal in many recipients experiencing the above-mentioned complications, the gastroenterologist, internist, or family practitioner frequently has a role in the diagnosis and management of these complications. In this review, we discuss the basic pathophysiological concepts and suggest guidelines for the diagnosis and management of frequent medical problems encountered after liver transplantation.