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Abstract
The development of nutritional and metabolic abnormalities represents an important burden in patients after liver transplantation (LT). Our study aimed at evaluating the incidence, time of onset, and risk factors for nutritional and metabolic abnormalities in patients after LT. The study was a single-center retrospective study. Consecutive patients undergoing elective LT from 2000 to 2016 were enrolled. The presence of at least two among arterial hypertension (AH), diabetes mellitus (DM), dyslipidemia, and obesity (BMI ≥ 30 Kg/m2) was utilized to define patients with the metabolic disorder (MD). Three hundred and fifteen patients were enrolled; the median age was 56 years (68% males). Non-alcoholic steatohepatitis (NASH) was the origin of liver disease in 10% of patients. During follow-up, 39% of patients developed AH, 18% DM, and 17% dyslipidemia. Metabolic disorders were observed in 32% of patients. The NASH etiology (OR: 6.2; CI 95% 0.5–3; p = 0.003) and a longer follow-up (OR: 1.2; CI 95% 0.004–0.02; p = 0.002) were associated with de novo MD. In conclusion, nutritional and metabolic disorders are a frequent complication after LT, being present in up to one-third of patients. The NASH etiology and a longer distance from LT are associated with de novo MD after LT.
Highlights
The development of nutritional and metabolic abnormalities represents an important burden in patients after liver transplantation (LT) [1]
Body mass index (BMI), diagnosis of diabetes mellitus (DM), arterial hypertension (AH), and dyslipidemia were derived from clinical records before LT and at 1, 3, 5, and 10 years after LT
A total of 315 patients submitted to liver transplantation were enrolled in the study (Figure 1), the median age was 56 years, 68% were males, and the most frequent origin of LT was the hepatitis C virus, followed by alcohol abuse
Summary
The development of nutritional and metabolic abnormalities represents an important burden in patients after liver transplantation (LT) [1]. LT patients may become overweight and even morbidly obese [1,2]. Non-alcoholic steatohepatitis (NASH) is increasing as a cause of liver disease which may lead to liver cirrhosis and end-stage liver disease. Non-alcoholic steatohepatitis is the most rapidly rising indication for LT in the United States, and it is projected to become the most common indication in future years [3,4]. Patients with a diagnosis of NASH are frequently overweight or obese [5,6], and nutritional and metabolic disorders have been found to persist or rapidly recur after LT [7,8,9]
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