Department of Gastroenterology, Clinical Division, Hepatology Branch, University of São Paulo School of Medicine, São Paulo, Brazil.
Expert Rev Gastroenterol Hepatol. 2013 May;7(4):361-4. doi: 10.1586/egh.13.19.
Liver transplantation is the standard of care for acute and chronic end-stage liver disease. Advances in medical therapy and surgical techniques have transformed the long-term survival of liver-transplant (LT) recipients. The prevalence of post-transplant cardiovascular complications has been rising with increased life expectancy after liver transplantation. Currently, deaths related to cardiovascular complications are one of the main causes of long-term mortality in LT recipients, as cardiovascular disease is the reason of 19-42% of non-liver-related mortality after transplant. On the other hand, metabolic syndrome is common among LT recipients before and after transplantation. In fact, their components (abdominal obesity, diabetes mellitus, hypertension and dyslipidemia) are often exacerbated by transplant-specific factors, such as immunosuppression, inappropriate diet, smoking and a sedentary lifestyle, and add a significant risk of developing atherosclerosis. These aspects are discussed in this article.
肝移植是治疗急性和慢性终末期肝病的标准方法。医学治疗和手术技术的进步改变了肝移植(LT)受者的长期生存率。随着肝移植后预期寿命的延长,移植后心血管并发症的发生率一直在上升。目前,与心血管并发症相关的死亡是 LT 受者长期死亡的主要原因之一,因为心血管疾病是移植后 19-42%非肝脏相关死亡的原因。另一方面,代谢综合征在 LT 受者移植前后很常见。事实上,它们的组成部分(腹部肥胖、糖尿病、高血压和血脂异常)经常因移植特异性因素而恶化,如免疫抑制、饮食不当、吸烟和久坐的生活方式,并增加了发生动脉粥样硬化的显著风险。本文讨论了这些方面。