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肝移植:代谢综合征的作用

Liver Transplantation: the Role of Metabolic Syndrome.

作者信息

Davis Brian C, Shadab Siddiqui M

机构信息

, MCV Box 980342, Richmond, VA, 23298-0342, USA.

出版信息

Curr Treat Options Gastroenterol. 2017 Jun;15(2):316-331. doi: 10.1007/s11938-017-0135-1.

Abstract

The long-term survival in liver transplant recipients (LTRs) is currently at an historical high level stemming from improvement in perioperative care, infection control, and immunosuppression medications. However, compared to the general population, LTRs have decreased survival. Metabolic diseases like hypertension, dyslipidemia, type 2 diabetes, and obesity are key determinants of long-term mortality in LTRs. The incidence and prevalence of these metabolic comorbidities is considerably higher in LTRs and likely results from a combination of factors including exposure to chronic immunosuppression, weight gain, and recurrence of chronic liver disease after liver transplantation (LT). Although there is currently little guidance in managing these metabolic conditions post-LT, recommendations are often extrapolated from non-transplant cohorts. In the current review, we explore the relationship between metabolic syndrome and its comorbidities in LTRs.

摘要

由于围手术期护理、感染控制和免疫抑制药物的改善,肝移植受者(LTRs)的长期生存率目前处于历史高位。然而,与普通人群相比,LTRs的生存率有所下降。高血压、血脂异常、2型糖尿病和肥胖等代谢性疾病是LTRs长期死亡率的关键决定因素。这些代谢合并症在LTRs中的发病率和患病率要高得多,可能是多种因素共同作用的结果,包括长期接受免疫抑制、体重增加以及肝移植(LT)后慢性肝病复发。尽管目前在LT后管理这些代谢状况方面几乎没有指导意见,但相关建议通常是从非移植队列中推断出来的。在本综述中,我们探讨了LTRs中代谢综合征及其合并症之间的关系。

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