Wednesday, December 09, 2009

Metabolic Syndrome Prevalent After Liver Transplant

But literature review finds evidence is inconclusive on syndrome's impact on long-term survival

(HealthDay News) -- Patients who receive liver transplants are at high risk for developing metabolic syndrome and resulting cardiovascular complications, but the impact on mortality and long-term survival are inconclusive, according to a review in the December Liver Transplantation.

Mangesh Pagadala, M.D., of the Cleveland Clinic Foundation, and colleagues conducted a literature review on the development of metabolic syndrome among transplant patients, including hypertension, dyslipidemia, diabetes mellitus and obesity, all of which can contribute to cardiovascular complications and mortality. The reviewers examined 21 studies and identified risk factors for metabolic syndrome and its constituent conditions, and assessed patient outcomes for those developing metabolic syndrome.

The researchers note that the prevalence of metabolic syndrome ranged from 43 to 58 percent among post-transplant patients. Among the risk factors for developing post-transplant metabolic syndrome were immunosuppression, older age at transplant, male sex, smoking history, higher pre-transplant body mass index, pre-transplant diabetes, the type of liver disease resulting in the transplant (hepatitis C, cryptogenic cirrhosis, or alcohol), and marital status. The reviewers further found that despite cardiovascular risk, potential organ rejection, and infection risk among transplant patients with metabolic syndrome, the effects on long-term survival and mortality were inconclusive.

"Strategies to reduce the development of metabolic syndrome after transplantation should include lifestyle modifications involving alterations in diet and increased physical activity. Additional measures that may be potentially beneficial include the use of lipid-lowering agents, the optimal control of blood glucose, and the use of tacrolimus instead of cyclosporine," the authors write.

Read the abstract or full text.

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