Year 2022 / Volume 114 / Number 10
Original
Metabolic syndrome before liver transplantation: does it have an impact on post liver transplantation outcome?

586-591

DOI: 10.17235/reed.2022.8384/2021

Julia Herreras López, Lorena Puchades, Tommaso Di Maira, Antonio José Cañada, Javier Maupoey, Rafael López-Andújar, Martín Prieto Castillo, Marina Berenguer Haym, Victoria Aguilera,

Abstract
Introduction: Metabolic syndrome (MS) and cardiovascular risk factors are common in liver transplant (LT) candidates and recipients. Cardiovascular events and de novo tumors are increasingly common causes of mortality in liver transplant recipients. The aim of this study were (i) assess the prevalence of MS in LT recipients and its growth over the years and (ii) determine if the presence of MS pre-LT is associated with a higher risk of post-LT cardiovascular events (CVE), de novo tumors or early and late survival. Patients and methods: A retrospective study was performed that included LT recipients from January 2012 to December 2017. Baseline features (MS before LT and at 1year post-LT) and outcomes (CVE, de novo tumors and survival) were recorded. Results: 483 recipients were included, MS was present in 20% of pre-LT with an increasing prevalence over time, from 16% in 2012 to 34% in 2017 (p=0.025). One-year post-LT, an additional 12% had developed de novo MS. At a median of 56-months follow-up, 13% developed a CVE and 9% a de novo tumor. One and 5-yr survival rates were 91% and 83% in those with pre-LT MS and 93% and 85% in those without (p=0.94).The presence of MS before LT was independently associated with a higher risk of post-LT CVE (HR: 2.66 IC (95%): 1.6-4.4 p< 0.001), but not with de novo tumors (p=0.94) nor early and late survival (p=0.58 and p=0.87). Conclusion: Pre-LT MS is increasing among LT candidates and is associated with a higher risk of post-LT morbidity CVE yet without affecting mortality.  
Share Button
New comment
Comments
No comments for this article
References
1) Saklayen M. The Global Epidemic of the Metabolic Syndrome. Current Hypertension Reports 2018;20:12-19.
2) Samson S, Garber A. Metabolic syndrome. Endocrinol Metab Clin North Am 2014;43:1-23.
3) Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 2007;49:403-414.
4) Harlid S, Myte R, Van Guelpen B. The Metabolic Syndrome, Inflammation, and Colorectal Cancer Risk: An Evaluation of Large Panels of Plasma Protein Markers Using Repeated, Pre diagnostic Samples. Mediators of Inflammation 2017;17:480-489.
5) Uzunlulu M, Telci O, A Oguz. Association between metabolic syndrome and cancer. Ann Nutr 2016;68: 173-179.
6) Adams L, Arauz O, Angus P, et al. Additive impact of pre-liver transplant metabolic factors on survival post-liver transplant. J Gastroenterol Hepatol 2016;31:1016-1024.
7) Eric Chak, Sammy Saab. Risk factors and incidence of de novo malignancy in liver transplant recipients: a systematic review. Liver Int 2010;30:1247-1258.
8) Levey As, Stevens LS, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150:604-611.
9) World Health Organization. Prevention of cardiovascular disease. Guidelines for assesment and management of cardiovascuar risk. WHO. 2007:156-78.
10) Grundy SM, Cleeman JI, Daniels SR, et al. American Heart association; national Heart, Lung, and blood institute. Diagnosis and management of metabolic syndrome. Circulation 2005;112:2735-2752
11) Said S, Mukherjee D, Whayne T. Interrelationships with Metabolic Syndrome, Obesity and Cardiovascular Risk. Curr Vasc Pharmacol 2016;14:415-418.
12) Laish I, Braun M, Mor E, et al. Metabolic syndrome in liver transplant recipients: Prevalence, risk factors and association with cardiovascular events. Liver transplantation 2011;17:15-22.
13) Jiménez-Pérez M, González-Grande R, Omonte E, et al. Metabolic complications in liver transplant recipients. World J Gastroenterol 2016;22:6416-6426.
14) Madhwal S, Atreja A, Albeldawdi M, et al. Is Liver Transplantation a Risk Factor for Cardiovascular Disease? A Meta-Analysis of Observational Studies. Liver transplantation 2012;18:1140-1146.
15) Fussner L, Heimbach J, Fan C, et al. Cardiovascular disease after liver transplantation: When, What, and Who Is at Risk. Liver Transpl 2015;21:889-896.
16) De Luca L, Westbrook R, A. Tsochatzis E. Metabolic and cardiovascular complications in the liver transplant recipient. Annals of Gastroenterology 2015;28: 182-192.
17) Chang A, Cortez A, Condoc A, et al. Metabolic syndrome in liver transplantation: a preopetarive and post operative concern. Surgey 2016;160:1111-7
18) Sastre L, García R, Gádara JG, Ruiz P, et al. Incidence, Predictors, and Impact on Survival of Long-term Cardiovascular Events After Liver Transplantation 2020;104:317-325.
19) Di Maira T, Rubin A ,Puchades L, et al. Framingham Score, Renal Dysfunction, and Cardiovascular Risk in Liver Transplant Patients. Liver transplantation 2015;21:812-822.
20) Laryea M, Watt KD, Molinari M, Walsh MJ, McAlister VC, Marotta PJ et al. Metabolic syndrome in liver transplant recipients: prevalence and association with major vascular events. Liver Traspl 2007;13:1109-1114.
21) Nicolau-Raducu R, Gitman M, Ganier D, et al. Adverse cardiac events after orthotopic liver transplantation: a cross-sectional study in 389 consecutive patients. Liver Transpl 2015;21:13-21.
22) Ashish A, Madhwal S, Cywinski J, et al. Cumulative Risk of Cardiovascular Events After Orthotopic Liver Transplantation. Liver transplantation 2012;18:370-375.
23) Davis B, Siddiqui MS. Liver Transplantation: the Role of Metabolic Syndrome. Curr Treat Options Gastroenterol 2017;15:316-331.
24) VanWagner LB, Lapin B, Levitsky J, et al. Early cardiovascular mortality after liver transplantation. Liver transplantation 2014;20:11-16.
25) VanWagner LB, Serper M, Kang R, et al. Factors Associated With Major Adverse Cardiovascular Events After Liver Transplantation Among a National Sample. Am J Transplant 2016;16:2684-2694.
26) Sonny A, Ibrahim A, Schuster A, et al. Impact and persistence of cirrhotic cardiomyopathy after liver transplant. Clin transplant 2016;30:986-993.
27 ) Ormazabal V, Nair S, Elfeky O, et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovascular Diabetology 2018;17:122-129.
28) Laakso M, Kusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat Rev Endocrinol 2014;10: 293-302.
29) Burra P, Rodriguez-Castro K. Neoplasic disease after liver transplantation: Focus on de novo neoplasms. World J Gastroenterol 2015;21:8753-8768.
30) Chak E, Saab S. Risk factors and incidence of de novo malignancy in liver transplant recipients: a systematic review. Liver Int 2010; 30:1247-1258.
31) De Luca L, Kalafateli M, Bianchi S, et al. Cardiovascular morbidity and mortality is increased post-liver transplantation even in recipients with no pre-existing risk factors. Liver Int 2019;39:1557-1565.
32) Dare AJ, Plank LD, Anthony R, et al. Additive effect of pretrasplant Obesity, diabetes and cardiovascular risk factors on outcomes after liver transplantation. Livertransplantation 2014;20:281-290.
Related articles

Digestive Diseases Image

Posterior reversible encephalopathy syndrome (PRES) in post liver transplantation

DOI: 10.17235/reed.2022.8694/2022

Letter

Ertapenem neurotoxicity in liver transplantation

DOI: 10.17235/reed.2021.8469/2021

Digestive Diseases Image

Percutaneous treatment of a splenorenal shunt with an atrial septal closure device

DOI: 10.17235/reed.2020.7701/2020

Review

Physical frailty in liver transplantation

DOI: 10.17235/reed.2020.7448/2020

Letter

Management of hepatic artery aneurysms

DOI: 10.17235/reed.2020.7219/2020

Digestive Diseases Image

Epithelioid hemangioendothelioma: a rare cause of a liver tumor

DOI: 10.17235/reed.2020.7127/2020

Editorial

Colorectal cancer screening and survival

DOI: 10.17235/reed.2018.5870/2018

Letter to the Editor

Post-transplant lymphoproliferative disease after liver transplantation

DOI: 10.17235/reed.2017.5387/2017

Original

Colonic diverticulosis and the metabolic syndrome: an association?

DOI: 10.17235/reed.2017.5009/2017

Letter to the Editor

Liver metastasis from colorectal cancer 12 years after liver transplantation

DOI: 10.17235/reed.2017.4507/2016

Original

Self-expanding metal stents in postoperative esophageal leaks

DOI: 10.17235/reed.2016.3987/2015

Citation tools
Herreras López J, Puchades L, Di Maira T, Cañada A, Maupoey J, López-Andújar R, et all. Metabolic syndrome before liver transplantation: does it have an impact on post liver transplantation outcome?. 8384/2021


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1359 visits.
This article has been downloaded 115 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 10/10/2021

Accepted: 18/01/2022

Online First: 20/01/2022

Published: 07/10/2022

Article revision time: 91 days

Article Online First time: 102 days

Article editing time: 362 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology