RT Journal Article
T1 Cardiovascular morbidity and mortality is increased post-liver transplantation even in recipients with no pre-existing risk factors.
A1 De Luca, Laura
A1 Kalafateli, Maria
A1 Bianchi, Simone
A1 Alasaker, Norah
A1 Buzzetti, Elena
A1 Rodriguez-Peralvarez, Manuel
A1 Thorburn, Douglas
A1 O'Beirne, James
A1 Patch, David
A1 Leandro, Gioacchino
A1 Westbrook, Rachel
A1 Tsochatzis, Emmanuel A
K1 Diabetes
K1 Immunosuppression
K1 Metabolic syndrome
K1 Renal function
K1 Statins
AB Post-liver transplant (LT) metabolic syndrome (PTMS) and cardiovascular (CVS) mortality are becoming increasingly prevalent following sustained improvements in post-LT survival. We investigated the prevalence and predictors of PTMS and CVS complications in a cohort of consecutive LT recipients. We reviewed prospectively collected data of patients (n = 928) who underwent LT (1995-2013) and survived at least 1-year post-LT or died before that due to a major CVS complication. Median follow-up was 85 months (IQR = 106). The prevalence of PTMS was 22.4% and it developed de novo in 183 recipients (19.7%). A total of 187 (20.2%) patients developed at least one CVS event post-LT within a median of 49 months (IQR = 85). Overall mortality rate was 22.6% (n = 210). Causes of death were CVS events (n = 45, 21.4%), malignancies (21%), liver-related deaths (20%) and infections (6.7%). Independent predictors of major CVS events were: documented CVS disease pre-LT (Hazard Ratio (HR) = 3.330; 95% CI = 1.620-6.840), DM (HR = 1.120; 95% CI 1.030-1.220), hypertension (HR = 1.140; 95% CI 1.030-1.270), dyslipidaemia (HR = 1.140; 95% CI 1.050-1.240) and creatinine levels at 1 year (HR = 1.010; 95% CI = 1.005-1.013). Among LT recipients without pre-LT CVS disease or MS components (n = 432), 85 recipients developed ≥1 CVS events (19.7%) with independent predictors being DM (HR = 1.150; 95% CI = 1.010-1.320), creatinine levels at 1 year (HR = 1.020; 95% CI = 1.010-1.030) and hypertension (HR = 1.190; 95% CI = 1.040-1.360). Post-LT patients are at increased risk of CVS morbidity even in the absence of pre-existing metabolic risk factors. Renal sparing immunosuppressive protocols might reduce CVS events post-LT.
YR 2019
FD 2019-06-18
LK http://hdl.handle.net/10668/14164
UL http://hdl.handle.net/10668/14164
LA en
NO De Luca L, Kalafateli M, Bianchi S, Alasaker N, Buzzetti E, Rodríguez-Perálvarez M, et al. Cardiovascular morbidity and mortality is increased post-liver transplantation even in recipients with no pre-existing risk factors. Liver Int. 2019 Aug;39(8):1557-1565
DS RISalud
RD Apr 12, 2025