Review

You have free access to this content

Posttransplant metabolic syndrome: An epidemic waiting to happen

  1. Mangesh Pagadala1,
  2. Srinivasan Dasarathy1,
  3. Bijan Eghtesad2,
  4. Arthur J. McCullough1,†,*

Article first published online: 24 NOV 2009

DOI: 10.1002/lt.21952

Issue

Liver Transplantation

Liver Transplantation

Volume 15, Issue 12, pages 1662–1670, December 2009

Additional Information

How to Cite

Pagadala, M., Dasarathy, S., Eghtesad, B. and McCullough, A. J. (2009), Posttransplant metabolic syndrome: An epidemic waiting to happen. Liver Transpl, 15: 1662–1670. doi: 10.1002/lt.21952

Author Information

  1. 1

    Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH

  2. 2

    Department of Hepatobiliary Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH

  1. †

    Telephone: 216-444-2766; FAX: 216-445-3889

*Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Mail Code A30, Cleveland, OH 44195

Publication History

  1. Issue published online: 24 NOV 2009
  2. Article first published online: 24 NOV 2009
  3. Manuscript Accepted: 15 SEP 2009
  4. Manuscript Received: 25 JUN 2009

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (110K)

REFERENCES

  • 1
    Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415–1428.
  • 2
    Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004; 109: 433–438.
  • 3
    Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–359.
  • 4
    Roberts MS, Angus DC, Bryce CL, Valenta Z, Weissfeld L. Survival after liver transplantation in the United States: a disease-specific analysis of the UNOS database. Liver Transpl 2004; 10: 886–897.
    Direct Link:
  • 5
    Reich D, Rothstein K, Manzarbeitia C, Munoz S. Common medical diseases after liver transplantation. Semin Gastrointest Dis 1998; 9: 110–125.
  • 6
    Stegall MD, Everson G, Schroter G, Bilir B, Karrer F, Kam I. Metabolic complications after liver transplantation. Diabetes, hypercholesterolemia, hypertension, and obesity. Transplantation 1995; 60: 1057–1060.
  • 7
    Laryea M, Watt KD, Molinari M, Walsh MJ, McAlister VC, Marotta PJ, et al. Metabolic syndrome in liver transplant recipients: prevalence and association with major vascular events. Liver Transpl 2007; 13: 1109–1114.
    Direct Link:
  • 8
    Hanouneh IA, Feldstein AE, McCullough AJ, Miller C, Aucejo F, Yerian L, et al. The significance of metabolic syndrome in the setting of recurrent hepatitis C after liver transplantation. Liver Transpl 2008; 14: 1287–1293.
    Direct Link:
  • 9
    Francioso S, Angelico F, Baiocchi L, Tisone G, Lenci I, Carbone M, et al. High prevalence of metabolic syndrome and long-term survival after liver transplantation. J Hepatol 2008; 48: S82.
  • 10
    Bianchi G, Marchesini G, Marzocchi R, Pinna AD, Zoli M. Metabolic syndrome in liver transplantation: relation to etiology and immunosuppression. Liver Transpl 2008; 14: 1648–1654.
    Direct Link:
  • 11
    Munoz SJ, Elgenaidi H. Cardiovascular risk factors after liver transplantation. Liver Transpl 2005; 11: S52–S56.
    Direct Link:
  • 12
    Reuben A. Long-term management of the liver transplant patient: diabetes, hyperlipidemia, and obesity. Liver Transpl 2001; 7: S13–S21.
    Direct Link:
  • 13
    Jindal RM, Sidner RA, Hughes D, Pescovitz MD, Leapman SB, Milgrom ML, et al. Metabolic problems in recipients of liver transplants. Clin Transplant 1996; 10: 213–217.
  • 14
    Navasa M, Bustamante J, Marroni C, Gonzalez E, Andreu H, Esmatjes E, et al. Diabetes mellitus after liver transplantation: prevalence and predictive factors. J Hepatol 1996; 25: 64–71.
  • 15
    Sutedja DS, Wai CT, Teoh KF, Lee YM, Diddapur RK, Isaac J, et al. Long-term post-liver transplant complications of renal impairment and diabetes mellitus: data from Singapore. Singapore Med J 2006; 47: 604–608.
  • 16
    Sheiner PA, Magliocca JF, Bodian CA, Kim-Schluger L, Altaca G, Guarrera JV, et al. Long-term medical complications in patients surviving > or = 5 years after liver transplant. Transplantation 2000; 69: 781–789.
  • 17
    Guckelberger O, Bechstein WO, Neuhaus R, Luesebrink R, Lemmens HP, Kratschmer B, et al. Cardiovascular risk factors in long-term follow-up after orthotopic liver transplantation. Clin Transplant 1997; 11: 60–65.
  • 18
    Bigam DL, Pennington JJ, Carpentier A, Wanless IR, Hemming AW, Croxford R, et al. Hepatitis C-related cirrhosis: a predictor of diabetes after liver transplantation. Hepatology 2000; 32: 87–90.
    Direct Link:
  • 19
    Baid S, Cosimi AB, Farrell ML, Schoenfeld DA, Feng S, Chung RT, et al. Posttransplant diabetes mellitus in liver transplant recipients: risk factors, temporal relationship with hepatitis C virus allograft hepatitis, and impact on mortality. Transplantation 2001; 72: 1066–1072.
  • 20
    Tueche SG. Diabetes mellitus after liver transplant: new etiologic clues and cornerstones for understanding. Transplant Proc 2003; 35: 1466–1468.
  • 21
    John PR, Thuluvath PJ. Outcome of patients with new-onset diabetes mellitus after liver transplantation compared with those without diabetes mellitus. Liver Transpl 2002; 8: 708–713.
    Direct Link:
  • 22
    Johnston SD, Morris JK, Cramb R, Gunson BK, Neuberger J. Cardiovascular morbidity and mortality after orthotopic liver transplantation. Transplantation 2002; 73: 901–906.
  • 23
    Munoz SJ, Deems RO, Moritz MJ, Martin P, Jarrell BE, Maddrey WC. Hyperlipidemia and obesity after orthotopic liver transplantation. Transplant Proc 1991; 23: 1480–1483.
  • 24
    Everhart JE, Lombardero M, Lake JR, Wiesner RH, Zetterman RK, Hoofnagle JH. Weight change and obesity after liver transplantation: incidence and risk factors. Liver Transpl Surg 1998; 4: 285–296.
    Direct Link:
  • 25
    Gisbert C, Prieto M, Berenguer M, Breto M, Carrasco D, de Juan M, et al. Hyperlipidemia in liver transplant recipients: prevalence and risk factors. Liver Transpl Surg 1997; 3: 416–422.
    Direct Link:
  • 26
    Dehghani SM, Taghavi SA, Eshraghian A, Gholami S, Imanieh MH, Bordbar MR, et al. Hyperlipidemia in Iranian liver transplant recipients: prevalence and risk factors. J Gastroenterol 2007; 42: 769–774.
  • 27
    Molloy RM, Komorowski R, Varma RR. Recurrent nonalcoholic steatohepatitis and cirrhosis after liver transplantation. Liver Transpl Surg 1997; 3: 177–178.
    Direct Link:
  • 28
    Carson K, Washington MK, Treem WR, Clavien PA, Hunt CM. Recurrence of nonalcoholic steatohepatitis in a liver transplant recipient. Liver Transpl Surg 1997; 3: 174–176.
    Direct Link:
  • 29
    Kim WR, Poterucha JJ, Porayko MK, Dickson ER, Steers JL, Wiesner RH. Recurrence of nonalcoholic steatohepatitis following liver transplantation. Transplantation 1996; 62: 1802–1805.
  • 30
    Charlton M, Kasparova P, Weston S, Lindor K, Maor-Kendler Y, Wiesner RH, et al. Frequency of nonalcoholic steatohepatitis as a cause of advanced liver disease. Liver Transpl 2001; 7: 608–614.
    Direct Link:
  • 31
    Contos MJ, Cales W, Sterling RK, Luketic VA, Shiffman ML, Mills AS, et al. Development of nonalcoholic fatty liver disease after orthotopic liver transplantation for cryptogenic cirrhosis. Liver Transpl 2001; 7: 363–373.
    Direct Link:
  • 32
    Poordad F, Gish R, Wakil A, Garcia-Kennedy R, Martin P, Yao FY. De novo non-alcoholic fatty liver disease following orthotopic liver transplantation. Am J Transplant 2003; 3: 1413–1417.
    Direct Link:
  • 33
    Lim LG, Cheng CL, Wee A, Lim SG, Lee YM, Sutedja DS, et al. Prevalence and clinical associations of posttransplant fatty liver disease. Liver Int 2007; 27: 76–80.
    Direct Link:
  • 34
    Seo S, Maganti K, Khehra M, Ramsamooj R, Tsodikov A, Bowlus C, et al. De novo nonalcoholic fatty liver disease after liver transplantation. Liver Transpl 2007; 13: 844–847.
    Direct Link:
  • 35
    Petrides AS, Vogt C, Schulze-Berge D, Matthews D, Strohmeyer G. Pathogenesis of glucose intolerance and diabetes mellitus in cirrhosis. Hepatology 1994; 19: 616–627.
    Direct Link:
  • 36
    Perseghin G, Mazzaferro V, Benedini S, Pulvirenti A, Coppa J, Regalia E, et al. Resting energy expenditure in diabetic and nondiabetic patients with liver cirrhosis: relation with insulin sensitivity and effect of liver transplantation and immunosuppressive therapy. Am J Clin Nutr 2002; 76: 541–548.
  • 37
    Tietge UJ, Selberg O, Kreter A, Bahr MJ, Pirlich M, Burchert W, et al. Alterations in glucose metabolism associated with liver cirrhosis persist in the clinically stable long-term course after liver transplantation. Liver Transpl 2004; 10: 1030–1040.
    Direct Link:
  • 38
    Merli M, Leonetti F, Riggio O, Valeriano V, Ribaudo MC, Strati F, et al. Glucose intolerance and insulin resistance in cirrhosis are normalized after liver transplantation. Hepatology 1999; 30: 649–654.
    Direct Link:
  • 39
    Alessiani M, Cillo U, Fung JJ, Irish W, Abu-Elmagd K, Jain A, et al. Adverse effects of FK 506 overdosage after liver transplantation. Transplant Proc 1993; 25: 628–634.
  • 40
    Trail KC, McCashland TM, Larsen JL, Heffron TG, Stratta RJ, Langnas AN, et al. Morbidity in patients with posttransplant diabetes mellitus following orthotopic liver transplantation. Liver Transpl Surg 1996; 2: 276–283.
    Direct Link:
  • 41
    Davidson JA, Wilkinson A, for the International Expert Panel on New-Onset Diabetes After Transplantation. New-onset diabetes after transplantation 2003 international consensus guidelines: an endocrinologist's view. Diabetes Care 2004; 27: 805–812.
  • 42
    Canzanello VJ, Schwartz L, Taler SJ, Textor SC, Wiesner RH, Porayko MK, et al. Evolution of cardiovascular risk after liver transplantation: a comparison of cyclosporine A and tacrolimus (FK506). Liver Transpl Surg 1997; 3: 1–9.
    Direct Link:
  • 43
    Neal DA, Gimson AE, Gibbs P, Alexander GJ. Beneficial effects of converting liver transplant recipients from cyclosporine to tacrolimus on blood pressure, serum lipids, and weight. Liver Transpl 2001; 7: 533–539.
    Direct Link:
  • 44
    Manzarbeitia C, Reich DJ, Rothstein KD, Braitman LE, Levin S, Munoz SJ. Tacrolimus conversion improves hyperlipidemic states in stable liver transplant recipients. Liver Transpl 2001; 7: 93–99.
    Direct Link:
  • 45
    Luke RG. Mechanism of cyclosporine-induced hypertension. Am J Hypertens 1991; 4: 468–471.
  • 46
    Mor E, Facklam D, Hasse J, Sheiner P, Emre S, Schwartz M, et al. Weight gain and lipid profile changes in liver transplant recipients: long-term results of the American FK506 Multicenter Study. Transplant Proc 1995; 27: 1126.
  • 47
    Abouljoud MS, Levy MF, Klintmalm GB, for the US Multicenter Study Group. Hyperlipidemia after liver transplantation: long-term results of the FK506/cyclosporine A US Multicenter trial. Transplant Proc 1995; 27: 1121–1123.
  • 48
    Meltzer AA, Everhart JE. Self-reported substantial 1-year weight change among men and women in the United States. Obes Res 1995; 3(suppl 2): 123s–134s.
  • 49
    Sanyal AJ, Campbell-Sargent C, Mirshahi F, Rizzo WB, Contos MJ, Sterling RK, et al. Nonalcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities. Gastroenterology 2001; 120: 1183–1192.
  • 50
    Guckelberger O, Mutzke F, Glanemann M, Neumann UP, Jonas S, Neuhaus R, et al. Validation of cardiovascular risk scores in a liver transplant population. Liver Transpl 2006; 12: 394–401.
    Direct Link:
  • 51
    Wahlstrom HE, Cooper J, Gores G, Rosen C, Wiesner R, Krom RA. Survival after liver transplantation in diabetics. Transplant Proc 1991; 23: 1565–1566.
  • 52
    Levy MF, Husberg BS, Goldstein RM, Backman L, McMillan RW, Gibbs JF, et al. Diabetes mellitus and liver transplantation. Hepatology 1992; 16: 50A.
  • 53
    Marchesini G, Marzocchi R. Metabolic syndrome and NASH. Clin Liver Dis 2007; 11: 105–117, ix.
  • 54
    Adams LA, Angulo P, Lindor KD. Nonalcoholic fatty liver disease. CMAJ 2005; 172: 899–905.
  • 55
    Diabetes Prevention Program Research Group. The Diabetes Prevention Program: baseline characteristics of the randomized cohort. Diabetes Care 2000; 23: 1619–1629.
  • 56
    Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 2006; 368: 1673–1679.
View Full Article (HTML) Get PDF (110K)