Abstract
(1) Background: Treatment of dyslipidemia via statin therapy in the non-liver transplant (LT) population is associated with a mortality benefit; however, the impact of statin therapy in post-LT population is not well-defined. This meta-analysis seeks to investigate the safety and efficacy of statin therapy in post-LT patients. (2) Methods: A systematic literature search on Medline and EMBASE database was conducted. A single-arm proportional meta-analysis and conventional pair-wise meta-analysis were performed to compare different outcomes with a random effects model. (3) Results: A total of 11 studies were included in this study, with 697 LT recipients identified to be on statin therapy. Statins were underutilized with only 32% (95% CI: 0.15–0.52) of 1094 post-LT patients on therapy. The incidence of adverse events of 14% (95% CI: 0.05–0.25) related to statin therapy was low. A significant mortality benefit was noted in patients on statin therapy with HR = 0.282 (95% CI: 0.154–0.517, p < 0.001), and improved lipid profiles post LT. The use of statins also significantly decreased odds of graft rejection (OR = 0.33; 95% CI: 0.15–0.73) and hepatocellular carcinoma (HCC) recurrence (HR = 0.32, 95% CI: 0.11–0.89). (4) Conclusions: Statin therapy is safe and efficacious in post-LT patients. Future studies to evaluate the effects of interactions between statins and immunosuppressant therapy are warranted.
Highlights
Hyperlipidemia in post-liver transplant (LT) patients is a common complication, occurring in 27–71%of liver-transplant recipients [1,2,3], and is an important risk factor for cardiovascular disease (CVD)
While statins have been proven safe in the general population [8], this remains unclear in the setting of transplant patients, with several observational studies showing varied results in outcomes such as mortality and adverse reactions [9,10,11]
A literature search was conducted on 15 December 2020, and relevant publications were identified by a search on Medline and Embase electronic databases using Boolean operators in “statin” and
Summary
Hyperlipidemia in post-LT patients is a common complication, occurring in 27–71%. Of liver-transplant recipients [1,2,3], and is an important risk factor for cardiovascular disease (CVD). The risk of cardiovascular (CVS) events in post-LT patients was found to be approximately 64% higher than in the general population [4] and was associated with non-raft-related morbidity and mortality in liver-transplant patients [5,6]. While statins have been proven safe in the general population [8], this remains unclear in the setting of transplant patients, with several observational studies showing varied results in outcomes such as mortality and adverse reactions [9,10,11].
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