Sheila Sherlock Liver Unit and University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Sheila Sherlock Liver Unit and University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, UK.
Lancet Gastroenterol Hepatol. 2019 Sep;4(9):731-741. doi: 10.1016/S2468-1253(19)30181-5.
Cardiovascular events are the second most prevalent cause of non-hepatic mortality in liver transplant recipients. The incidence of these events is projected to rise because of the growing prevalence of non-alcoholic steatohepatitis as a transplant indication and the ageing population of liver transplant recipients. Recipients with metabolic syndrome are up to four times more likely to have a cardiovascular event than recipients without, therefore prevention and optimal treatment of the components of metabolic syndrome are key in reducing the risk of these events. Although data on the treatment of metabolic comorbidities specifically in liver transplant recipients are scarce, there is detailed guidance from learned societies that mostly mirrors the guidance for patients at increased cardiovascular risk in the general population. In this Review, we discuss the management of the components of metabolic syndrome following liver transplantation and provide practical stepwise guidance. We also emphasise the need for adequately powered studies for the treatment of metabolic comorbidities in liver transplant recipients.
心血管事件是肝移植受者非肝脏相关死亡的第二大常见原因。由于非酒精性脂肪性肝炎作为移植适应证的患病率不断增加以及肝移植受者人口老龄化，这些事件的发生率预计将会上升。患有代谢综合征的受者发生心血管事件的可能性比没有代谢综合征的受者高 4 倍，因此预防和优化代谢综合征各组分的治疗是降低这些事件风险的关键。尽管针对肝移植受者中代谢合并症的具体治疗的数据很少，但专业学会提供了详细的指导，这些指导主要反映了普通人群中心血管风险增加患者的指导。在这篇综述中，我们讨论了肝移植后代谢综合征各组分的管理，并提供了实用的逐步指导。我们还强调了需要进行足够有力的研究来治疗肝移植受者的代谢合并症。
