Metabolic syndrome and liver transplantation: A review and guide to management

Watt, Kymberly D.; Charlton, Michael

doi:10.1016/j.jhep.2010.01.040

Cited by 196 publications

(172 citation statements)

References 102 publications

Supporting

Mentioning

153

Contrasting

Unclassified

Order By: Relevance

“…12,13 Alcoholic cirrhosis Patients were confirmed as having alcoholic cirrhosis based on histologic results and/or clinical diagnosis of cirrhosis and exclusion of other causes of liver disease except hepatitis C virus infection and on documentation of alcohol abuse (> 14 drinks/wk in men and > 7 drinks/wk in women for > 5 years).…”

Section: Metabolic Syndromementioning

confidence: 99%

Untitled

Piazza

Singal²

2016

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Frequency of liver transplants because of nonalcoholic steatohepatitis is increasing. Data are conflicting on nonalcoholic steatohepatitis as a risk factor for cardiovascular events after transplant. Materials and Methods:We reviewed medical records of liver transplant recipients (between years 2005 and 2010) for alcoholic cirrhosis or nonalcoholic steatohepatitis for cardiovascular events (arrhythmia, congestive heart failure, coronary disease, pulmonary hypertension, or stroke) and patient survival within 3 years. Results: Compared with the 65 transplant recipients for alcoholic cirrhosis, the 78 transplant recipients for nonalcoholic steatohepatitis were significantly (P < .0001 for all) more likely to be female (46% vs 8%), have a larger mean body mass index (34 ± 7 vs 29 ± 5), more likely to have diabetes (58% vs 26%), less likely to be hepatitis C virus-positive (3% vs 29%), and less likely to smoke (29% vs 69%). Eleven patients with nonalcoholic steatohepatitis and 9 patients with nonalcoholic steatohepatitis had cardiovascular events; however, these groups were not significantly different 1 year (7.7% vs 6.1%; P = .45) or 3 years (14.1% vs 13.8%; P = .9) after liver transplant. The odds of having a cardiovascular event were about 9-fold greater for patients with concomitant hepatitis C virus and 3-fold greater for men. Eighteen patients died, with patients with cardiovascular events having greater than 4-fold increased mortality (mean 4.1-fold; range, 1.2-fold to 13.9-fold). Conclusions: Cardiovascular events occurred with similar frequency in transplant recipients for nonalcoholic steatohepatitis or alcoholic cirrhosis. Patient survival was affected in both groups, but male patients with concomitant hepatitis C virus infection remained at higher risk for a cardiovascular event after liver transplant. Development of a cardiac evaluation protocol for liver transplant recipients could help monitor these patients.

show abstract

Section: Metabolic Syndromementioning

confidence: 99%

Untitled

Piazza

Singal²

2016

Exp Clin Transplant

View full text Add to dashboard Cite

show abstract

“…291 Compared with the nondialysis general population, age-, race-, and sex-matched kidney transplant recipients (25-55 years) have a significantly higher CVD mortality. 292 Metabolic disorders, such as diabetes, hyperlipidemia, arterial hypertension and proteinuria are widely observed in liver and kidney transplant recipients, [293][294][295] and are risk factors for CVEs. Marked increases in these disorders are evident after both liver and kidney transplantation.…”

Section: Cardiovascular Complications After Kidney and Liver Transplamentioning

confidence: 99%

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

View full text Add to dashboard Cite

Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

show abstract

“…(2) Indeed, a higher incidence of MS in LT recipients (approximately 40%-58%), compared to the general population, has not only been reported in patients transplanted for NASH cirrhosis but also in patients transplanted for other indications. (3) Recurrent NAFLD and NASH are common with reported prevalences ranging from 30% to 100% and from 21% to 73%, respectively. (4) NAFLD/NASH recurrence correlates with higher pre-and post-LT BMI, diabetes, hyperlipidemia, and cumulative steroid dose at 6 months after LT.…”

Section: See Article On Page 644mentioning

confidence: 99%