Metabolic syndrome following liver transplantation in nonalcoholic steatohepatitis

Spiritos, Zachary; Abdelmalek, Manal F.

doi:10.21037/tgh.2020.02.07

Cited by 16 publications

(19 citation statements)

References 64 publications

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“…According to previous studies (14,17,18) there are variable prevalence of de novo NAFLD or recurrent NAFLD/NASH with different outcomes after LT. Recurrent NAFLD appears to be an earlier, more severe and with negative patient and graft outcomes. The recurrence of NAFLD has been reported to occur in 8.2-62.5% of recipients over variable follow-up periods ranging from <6 months to 10 years, and the rates for steatohepatitis have ranged from 4 to 33% over follow-up periods ranging from 6 weeks to 20 years.…”

Section: Frequency Progression and Significance Of Post-transplant Nafldmentioning

confidence: 99%

“…Fibrates can be also safely used in patients with high triglyceridemia levels over 600 mg/dL, but caution is required when co-administrated with statins due to high risk of myotoxicity and renal dysfunction. For patients with hypertriglyceridemia, fish oil can be used with minimal side effects except potential increase of low-density lipoprotein level (18,30).…”

Section: Obesitymentioning

confidence: 99%

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Genetic and Life Style Risk Factors for Recurrent Non-alcoholic Fatty Liver Disease Following Liver Transplantation

et al. 2022

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Recurrent or de novo non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) following liver transplantation (LT) is a frequent event being increasingly recognized over the last decade, but the influence of recurrent NASH on graft and patient outcomes is not yet established. Taking into consideration the long term survival of liver transplanted patients and long term complications with associated morbidity and mortality, it is important to define and minimize risk factors for recurrent NAFLD/NASH. Metabolic syndrome, obesity, dyslipidemia, diabetes mellitus are life style risk factors that can be potentially modified by various interventions and thus, decrease the risk of recurrent NAFLD/NASH. On the other hand, genetic factors like recipient and/or donor PNPLA3, TM6SF2, GCKR, MBOAT7 or ADIPOQ gene polymorphisms proved to be risk factors for recurrent NASH. Personalized interventions to influence the different metabolic disorders occurring after LT in order to minimize the risks, as well as genetic screening of donors and recipients should be performed pre-LT in order to achieve diagnosis and treatment as early as possible.

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Section: Frequency Progression and Significance Of Post-transplant Nafldmentioning

confidence: 99%

Section: Obesitymentioning

confidence: 99%

Genetic and Life Style Risk Factors for Recurrent Non-alcoholic Fatty Liver Disease Following Liver Transplantation

et al. 2022

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“…NAFLD is the major chronic liver disease in the world and represents the hepatic symptom of MetS [127,128]. NAFLD affects one in four adults and is expected to increase annually in parallel with the increase in MetS prevalence [129].…”

Section: Non-alcoholic Fatty Liver Disease (Nafld)mentioning

confidence: 99%

Propolis in Metabolic Syndrome and Its Associated Chronic Diseases: A Narrative Review

et al. 2021

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Propolis is a resinous product collected by bees from plants to protect and maintain the homeostasis of their hives. Propolis has been used therapeutically by humans for centuries. This review article attempts to analyze the potential use of propolis in metabolic syndrome (MetS) and its associated chronic diseases. MetS and its chronic diseases were shown to be involved in at least seven out of the top 10 causes of death in 2019. Patients with MetS are also at a heightened risk of severe morbidity and mortality in the present COVID-19 pandemic. Propolis with its antioxidant and anti-inflammatory properties is potentially useful in ameliorating the symptoms of MetS and its associated chronic diseases. The aim of this article is to provide a comprehensive review on propolis and its therapeutic benefit in MetS and its chronic diseases, with an emphasis on in vitro and in vivo studies, as well as human clinical trials. Moreover, the molecular and biochemical mechanisms of action of propolis are also discussed. Propolis inhibits the development and manifestation of MetS and its chronic diseases by inhibiting of the expression and interaction of advanced glycation end products (AGEs) and their receptors (RAGEs), inhibiting pro-inflammatory signaling cascades, and promoting the cellular antioxidant systems.

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“…Immunosuppression-related metabolic derangements (obesity, diabetes mellitus, dyslipidemia, and hypertension) affect clinical decisions about the choice of immunosuppressive agent. Moreover, these derangements have accelerated occurrence and have ominous outcomes that endanger grafts' durability and patients' survival [16][17][18]. Earlier reports claimed that the prevalence of post-liver-transplant metabolic syndrome ranges from 43 to 59% for transplants of any etiology and up to 90% in patients who received transplants for non-alcoholic fatty liver disease (NASH).…”

Section: Effects Of Immune-suppressive Agents On Recipients' Healthmentioning

confidence: 99%

Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review

2021

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Since the first liver transplantation operation (LT) in 1967 by Thomas Starzl, efforts to increase survival and prevent rejection have taken place. The development of calcineurin inhibitors (CNIs) in the 1980s led to a surge in survival post-transplantation, and since then, strategies to prevent graft loss and preserve long-term graft function have been prioritized. Allograft rejection is mediated by the host immune response to donor antigens. Prevention of rejection can be achieved through either immunosuppression or induction of tolerance. This leads to a clinical dilemma, as the choice of an immunosuppressive agent is not an easy task, with considerable patient and graft-related morbidities. On the other hand, the induction of graft tolerance remains a challenge. Despite the fact that the liver exhibits less rejection than any other transplanted organs, spontaneous graft tolerance is rare. Most immunosuppressive medications have been incriminated in renal, cardiovascular, and neurological complications, relapse of viral hepatitis, and recurrence of HCC and other cancers. Efforts to minimize immunosuppression are directed toward decreasing medication side effects, increasing cost effectiveness, and decreasing economic burden without increasing the risk of rejection. In this article, we will discuss recent advances in strategies for improving immunosuppression following liver transplantation.

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Metabolic syndrome following liver transplantation in nonalcoholic steatohepatitis

Cited by 16 publications

References 64 publications

Genetic and Life Style Risk Factors for Recurrent Non-alcoholic Fatty Liver Disease Following Liver Transplantation

Genetic and Life Style Risk Factors for Recurrent Non-alcoholic Fatty Liver Disease Following Liver Transplantation

Propolis in Metabolic Syndrome and Its Associated Chronic Diseases: A Narrative Review

Strategies to Improve Immune Suppression Post-Liver Transplantation: A Review

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