High Frequency of Arterial Hypertension in Patients After Liver Transplantation

Gojowy, Damian; Adamczak, Marcin; Dudzicz, Sylwia; Gazda, Magdalena; Karkoszka, Henryk; Wiȩcek, Andrzej

doi:10.1016/j.transproceed.2015.11.043

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…For instance, the prevalence of hypertension was 54.7% in liver transplant recipients, similar to that described by others. 6 In contrast, the prevalence of hypertension among the general population was 30.4%. 26 The prevalence of hypercholesterolemia in our cohort was 25.0%, which is almost double that described in the general population.…”

Section: Discussionmentioning

confidence: 94%

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Saab¹,

Sikavi²,

Jimenez³

et al. 2017

Journal of Clinical and Translational Hepatology

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Background and Aims: Given the increased risk of post-transplant metabolic syndrome (PTMS; defined by hypertension, diabetes mellitus and hyperlipidemia), we aimed to identify the potential role of food addiction in the development of metabolic complications in the post-liver transplant population.Methods: Inclusion criteria included adult liver transplant recipients followed at our institution between June 2016 and November 2016. Participants were administered a demographic survey as well as the Yale Food Assessment Scale 2.0, a 35-item questionnaire used to assess frequency of food addiction in accordance with the DSM-V guidelines of substance use disorders. Demographic and clinical data were collected.Results: Our study included 236 liver transplant recipients (139 males, 97 females). The median (interquartile range [IQR]) BMI of participants was 26.8 kg/m2 (24.2, 30.4), and median (IQR) time since transplantation was 50.9 months (19.6, 119.8). The prevalence rates of hypertension, hypercholesterolemia and diabetes mellitus were 54.7%, 25.0% and 27.1%, respectively. Twelve participants (5.1%) were found to have a diagnosis of food addiction. A diagnosis of food misuse was made in 94 (39.8%) of the transplant recipients.Conclusions: Our findings are consistent with prior data that indicate high prevalence of metabolic complications among liver transplant recipients. Food addiction was not predictive of metabolic complications within this population. Nevertheless, we found that this population was at high risk of demonstrating symptoms of food misuse, and they were not likely to appreciate the risks of pathologic patterns of eating. Given the increasing risk of cardiovascular morbidity and mortality in this population, efforts should be made to identify risk factors for the development of PTMS.

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Section: Discussionmentioning

confidence: 94%

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Saab¹,

Sikavi²,

Jimenez³

et al. 2017

Journal of Clinical and Translational Hepatology

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“…The development of systemic arterial hypertension in the transplanted patient is associated with the use of immunosuppressive drugs, and many studies relate it to the use of cyclosporine and tacrolimus, which are calcineurin-inhibiting drugs (12)(13)(14) , since they cause endothelial dysfunction and compromises the vasodilator response, besides producing vasoconstrictor substances and activating the renin angiotensin aldosterone system. Cyclosporine is the immunosuppressive drugs which is most associated with systemic arterial hypertension (15,16) when compared to tacrolimus. According to the article by Canzanello VJ et al (17) , only 33% of patients who used tacrolimus developed SAH, against those who used cyclosporine, in which 82% of patients became hypertensive.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Time of Development of Systemic Arterial Hypertension in Patients After Liver Transplantation

Lemos

Silva

2021

Arq. Gastroenterol.

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BACKGROUND: The use of immunosuppressive drugs after liver transplantation (LT) is associated with the development of systemic arterial hypertension (SAH), in addition to other comorbidities of metabolic syndrome. OBJECTIVE: Therefore, the purpose of this study was to analyze the time after use immunosuppressive drugs the patient progresses to SAH, as well as to identify its prevalence and the factors that may be correlated to it. METHODS: A retrospective and longitudinal study was conducted, based on the analysis of medical records of 72 normotensive patients, attended in the transplant unit of a university hospital, between 2016 and 2019. RESULTS: It was observed, on average, 9±6.98 months after immunosuppressive use, the patients were diagnosed with hypertension, and the prevalence of transplanted patients who evolved to SAH in this study was 59.64% (41 patients). In addition, there was a correlation between serum dosage of tacrolimus and the development of SAH (P=0.0067), which shows that tacrolimus has a significant role in the development of SAH. Finally, it was noticed that the development of post-transplantation hypertension indicates a higher risk of the patient presenting the other parameters of metabolic syndrome, as well as a higher impairment in its renal function (P=0.0061). CONCLUSION: This study shows that the patients evolved to SAH in an average of 9±6.98 months after immunosuppressive drug use. We have also found high prevalence of systemic arterial hypertension (59.64%) in patients after liver transplantation, who used calcineurin inhibitors, especially when associated with the use of tacrolimus.

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“…Arterial hypertension is present in 30%-50% of patients after LT, with prevalence rates of nearly 70% over long-term follow-up. 71 The aetiology of post-LT hypertension is related not only to post-LT haemodynamic changes, but also to the use of immunosuppressive therapy, in particular calcineurin inhibitors (CNIs). Reducing the use of immunosuppressive drugs, as well as lifestyle modifications such as reducing sodium intake and stopping smoking, represent the first-line therapy to decrease the risk of arterial hypertension.…”

Section: Arterial Hypertensionmentioning

confidence: 99%

NAFLD and liver transplantation: Disease burden, current management and future challenges

2020

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Non-alcoholic fatty liver disease (NAFLD), specifically its progressive form non-alcoholic steatohepatitis (NASH), represents the fastest growing indication for liver transplantation in Western countries. Diabetes mellitus, morbid obesity and cardiovascular disease are frequently present in patients with NAFLD who are candidates for liver transplantation. These factors require specific evaluation, including a detailed pre-surgical risk stratification, in order to improve outcomes after liver transplantation. Moreover, in the post-transplantation setting, the incidence of cardiovascular events and metabolic complications can be amplified by immunosuppressive therapy, which is a well-known driver of metabolic alterations. Indeed, patients with NASH are more prone to developing early post-transplant complications and, in the long-term, de novo malignancy and cardiovascular events, corresponding to higher mortality rates. Therefore, a tailored multidisciplinary approach is required for these patients, both before and after liver transplantation. Appropriate candidate selection, lifestyle modifications and specific assessment in the pre-transplant setting, as well as pharmacological strategies, adjustment of immunosuppression and a healthy lifestyle in the post-transplant setting, play a key role in correct management.

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High Frequency of Arterial Hypertension in Patients After Liver Transplantation

Cited by 14 publications

References 17 publications

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Clinical Food Addiction Is Not Associated with Development of Metabolic Complications in Liver Transplant Recipients

Prevalence and Time of Development of Systemic Arterial Hypertension in Patients After Liver Transplantation

NAFLD and liver transplantation: Disease burden, current management and future challenges

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