Metabolic Disorders in Liver Transplant Recipients: The State of the Art.
Filippo GabrielliLucia GolfieriFabio NascimbeniPietro AndreoneStefano GittoPublished in: Journal of clinical medicine (2024)
Liver transplantation represents a chief therapeutic approach for acute liver failure, end-stage liver disease and hepatocellular carcinoma. Despite witnessing advancements in short- and medium-term survival over recent decades, attributed to refinements in surgical techniques and immunosuppressive protocols, long-term mortality remains impervious to modification. Notably, cardiovascular disease emerges as a predominant cause of mortality among liver transplant recipients. This trend is accentuated by the increasing prominence of non-alcoholic steatohepatitis-related cirrhosis as an indication for liver transplantation. Moreover, the administration of immunosuppressive agents is intricately linked to the degradation of the metabolic profile in liver transplant recipients, thereby contributing to the initiation or exacerbation of cardiovascular risk factors, such as hypertension, diabetes, and dyslipidaemia. In addition, the post-liver transplantation period is marked by a decline in lifestyle quality and a failure to acknowledge the psychological distress experienced by patients throughout the transplant process. These factors can precipitate a deterioration in the patient's metabolic profile, exacerbated by suboptimal therapeutic compliance. This narrative review aims to comprehensively address the principal metabolic disorders intricately associated with liver transplantation.
Keyphrases
- liver failure
- cardiovascular disease
- cardiovascular risk factors
- cardiovascular events
- type diabetes
- hepatitis b virus
- end stage renal disease
- metabolic syndrome
- blood pressure
- ejection fraction
- newly diagnosed
- chronic obstructive pulmonary disease
- risk factors
- drug induced
- peritoneal dialysis
- prognostic factors
- preterm infants
- intensive care unit
- liver injury
- respiratory failure
- patient reported outcomes
- sleep quality
- quality improvement
- skeletal muscle
- free survival
- insulin resistance
- depressive symptoms
- extracorporeal membrane oxygenation