Obesity

Metabolic Syndrome – A Risk of Liver Transplant

As technical improvements in liver transplant surgery and pre- and post-operative care continue, liver transplant patients are living longer.  Experts are finding that metabolic syndrome and its manifestations of cardiovascular disease and diabetes are a growing concern for this population.  According to a research study carried out by experts at the Rabin Medical Center in Israel, 52 percent of patients who underwent a liver transplant developed metabolic syndrome post surgery while only 5 percent had metabolic syndrome prior to surgery.  That 52 percent is double the rate of the general population.  A substantial rise in complications such as obesity, high blood pressure, high triglycerides, high LDL (bad) cholesterol levels and type 2 diabetes after the transplantation surgery took place were found.  The results of the study are published in the January 2011 issue of Liver Transplantation.

What researchers learned about the complications of liver transplant and metabolic syndrome:

  • Choice of food intake, which can cause weight gain; drugs which suppress the immune system like corticosteroids and calcineurin inhibitors; the presence of liver disease itself including fatty liver disease (nonalcoholic) and hepatitis C infection are the probable significant causes of metabolic syndrome in these patients according to prior studies.
  • The study was done to understand how prevalent metabolic syndrome is along with its associated risk factors in liver transplant patients.
  • Researchers reviewed the records of 252 patients who had a liver transplant between 1985 and 2007.
  • Researchers analyzed weight, height, prescribed medications, blood pressure, presence of diabetes, hyperlipidemia and waist circumference prior to and after the transplantation in the subjects.
  • Researches diagnosed metabolic syndrome post transplantation when at least three of the criteria were observed in the patients:

High BMI (obesity)

High blood pressure

High triglycerides levels in the blood while fasting

Increased waist circumference (abdominal fat)

High fasting blood sugar

Low HDL (good) cholesterol

 

The study found significantly higher rates of obesity, elevated triglycerides, high blood pressure, type 2 diabetes and low HDL (good) cholesterol in subjects after their liver transplants.  They also noted that many of the patients that were found to have metabolic syndrome after their liver transplant were older and heavier then those who did not develop it.  These patients also had a higher rate of hepatitis C infection prior to surgery as well as a higher risk for major cardiac and vascular events post surgery.  The conclusion stated that metabolic syndrome is most definitely associated with cardiovascular morbidity but not mortality.

These findings show the need for better patient management both before and after surgery including lifestyle modification, weight loss, diet, blood glucose control and possible medications to help lower cholesterol and/or blood pressure.

 

References

Metabolic Syndrome in Liver Transplant Recipients: Prevalence, Risk Factors, and
Association With Cardiovascular Events:
http://medicina.udea.edu.co/gastrohepatologia/articulos/2011-II/Sx_metabolico_postTH,_liver_t_2011%5B1%5D.pdf

Metabolic syndrome in liver transplant recipients: prevalence, risk factors, and association with cardiovascular events:
http://www.ncbi.nlm.nih.gov/pubmed/21254340

Metabolic Syndrome Is a Risk after Liver Transplantation, Leading to Poor Outcomes:
http://www.hivandhepatitis.com/hep_c/news/2010/011510_b.html

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