Luca Laura De, Westbrook Rachel, Tsochatzis Emmanuel A
Sheila Sherlock Liver Unit and UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Ann Gastroenterol. 2015 Apr-Jun;28(2):183-192.
Metabolic syndrome (MS) is an established risk factor for atherosclerosis and cardiovascular disease that affects 20-30% of the adult population in the western world, correlating with increased incidence of cardiovascular disease. Survival following liver transplantation (LT) has been steadily improving over the last 2 decades, with graft loss becoming a relatively rare cause of morbidity and mortality post LT. The improvement in short-term survival following LT has resulted in an increased incidence of metabolic and cardiovascular complications, which affect the mid- and long term survival. Patients following LT typically gain weight and might develop diabetes, hypertension and dyslipidemia as a consequence of their immunosuppressive therapy and their lifestyle. In this paper we review the prevalence of metabolic and cardiovascular complications following LT, their impact on post-transplant morbidity and mortality and their optimal management.
代谢综合征(MS)是动脉粥样硬化和心血管疾病的既定危险因素,影响着西方世界20%-30%的成年人口,与心血管疾病发病率的增加相关。在过去20年中,肝移植(LT)后的生存率一直在稳步提高,移植肝丢失已成为LT后发病率和死亡率相对罕见的原因。LT后短期生存率的提高导致了代谢和心血管并发症的发病率增加,这些并发症影响着中长期生存。LT后的患者通常会体重增加,并且由于免疫抑制治疗和生活方式的原因,可能会出现糖尿病、高血压和血脂异常。在本文中,我们综述了LT后代谢和心血管并发症的患病率、它们对移植后发病率和死亡率的影响以及它们的最佳管理方法。