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Review
. 2022 Jul 14;11(14):4080.
doi: 10.3390/jcm11144080.

Dyslipidemia in Transplant Patients: Which Therapy?

Gabriella Iannuzzo  1 , Gianluigi Cuomo  2 , Anna Di Lorenzo  2 , Maria Tripaldella  1 , Vania Mallardo  1 , Paola Iaccarino Idelson  1 , Caterina Sagnelli  3 , Antonello Sica  4 , Massimiliano Creta  5 , Javier Baltar  6 , Felice Crocetto  5 , Alessandro Bresciani  7 , Marco Gentile  1 , Armando Calogero  6 , Francesco Giallauria  2
Affiliations
Review

Dyslipidemia in Transplant Patients: Which Therapy?

Gabriella Iannuzzo et al. J Clin Med. .

Abstract

Cardiovascular disease is the most important cause of death worldwide in recent years; an increasing trend is also shown in organ transplant patients subjected to immunosuppressive therapies, in which cardiovascular diseases represent one of the most frequent causes of long-term mortality. This is also linked to immunosuppressant-induced dyslipidemia, which occurs in 27 to 71% of organ transplant recipients. The aim of this review is to clarify the pathophysiological mechanisms underlying dyslipidemia in patients treated with immunosuppressants to identify immunosuppressive therapies which do not cause dyslipidemia or therapeutic pathways effective in reducing hypercholesterolemia, hypertriglyceridemia, or both, without further adverse events.

Keywords: cardiovascular disease; dyslipidemia; immunosuppressive therapy; organ transplant.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of atherosclerosis in transplant patients.
Figure 2
Figure 2
A suggest algorithm to managing dyslipidemia in transplant patients. Atorva: atorvastatin; AZA: azathioprine; CsA: cyclosporine; CVD: cardiovascular diseases; Eze: ezetimibe; Fluva: fluvastatin; o.d.: once daily; LDL: low-density lipoprotein; MMF: mycophenolate mofetil; mTORi: mammalian target of rapamycin inhibitors; PCSK9: Proprotein convertase subtilisin/kexin 9; Prava: pravastatin; Rosuva: rosuvastatin (* should be avoided severe chronic kidney disease); Tac: tacrolimus. Yellow color: low-intensity statin, expected LDL circulating reduction <30%; Orange color: moderate-intensity statin, expected LDL circulating reduction 30–50%; Red color: high-intensity statin or PCSK9i, expected LDL circulating reduction >50%; Color gradient for Eze indicates differences in LDL circulating reduction if ezetimibe is administered alone or co-administered with statin.
See this image and copyright information in PMC

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