Cardiovascular risk factors after liver transplantation: analysis of related factors.

AIMS

We sought to analyze the cardiovascular risk factors (CVRF) in liver transplantation and their relation to immunosuppression and hepatitis C virus (HCV) infection.

PATIENTS AND METHODS

The study included all 158 liver transplants performed between January 2005 and December 2008 that had a minimum follow-up of 1 year. There were 104 men (64%) and 54 women (36%). Data were recorded on both the pretransplant prevalence as well as new cases of diabetes mellitus (DM), hypertension, hypertriglyceridemia, hypercholesterolemia, and hyperuricemia, defined by the need for drug therapy, after a mean follow-up period of 38 months (range, 12-64). We also examined the influence on CVRF of immunosuppression and HCV.

RESULTS

Tacrolimus was prescribed for 61% of the patients and cyclosporine, 39%. Upon univariate analysis only hypertension was significantly associated with the use of cyclosporine (P < .03). There was a trend to a greater incidence of hypercholesterolemia with cyclosporine (P = .1) and DM with tacrolimus (P = .1). The presence of HCV was significantly associated with a greater incidence of de novo DM (P < .01), as was a severe relapse of hepatitis C (P < .03). Multivariate analysis showed a 4.4 times greater risk for developing de novo DM among patients with a severe relapse of HCV.

CONCLUSION

The development of CVRF after liver transplantation was manifested, mainly during the first 3 months posttransplantation. Special attention should be given to the risk for de novo DM among HCV positive patients.