Metabolic and cardiovascular complications in the liver transplant recipient

Abstract

Metabolic syndrome (MS) is an established risk factor for atherosclerosis and cardiovascular disease that affects 20-30% of the adult population in the western world, correlating with increased incidence of cardiovascular disease. Survival following liver transplantation (LT) has been steadily improving over the last 2 decades, with graft loss becoming a relatively rare cause of morbidity and mortality post LT. The improvement in short-term survival following LT has resulted in an increased incidence of metabolic and cardiovascular complications, which affect the mid- and long term survival. Patients following LT typically gain weight and might develop diabetes, hypertension and dyslipidemia as a consequence of their immunosuppressive therapy and their lifestyle. In this paper we review the prevalence of metabolic and cardiovascular complications following LT, their impact on post-transplant morbidity and mortality and their optimal management.

Keywords: Liver transplantation; NAFLD; NASH; cardiovascular disease; diabetes mellitus; dyslipidemia; epidemiology; hypertension; metabolic syndrome; morbidity; mortality; obesity; risk factors.

Figure 1

Etiology of death in liver transplant recipients 1 year post transplant [20]