High prevalence of early atherosclerotic and cardiac damage in patients undergoing liver transplantation: Preliminary results

Giuseppina Pisano, Maria Francesca Donato, Dario Consonni, Giovanna Oberti, Vittorio Borroni, Rosa Lombardi, Federica Invernizzi, Cristina Bertelli, Lucio Caccamo, Marianna Porzio, Daniele Dondossola, Giorgio Rossi, Silvia Fargion, Anna Ludovica Fracanzani

Research output: Contribution to journalArticle

Abstract

Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.

Original languageEnglish
JournalDigestive and Liver Disease
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Liver Transplantation
Transplants
Waiting Lists
Lost to Follow-Up
Adiposity
Dyslipidemias
Adipose Tissue
Hepatocellular Carcinoma
Fibrosis
Steroids
Hypertension
Liver

Keywords

  • Carotid IMT
  • EAT
  • OLT
  • Visceral adiposity atherosclerosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

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title = "High prevalence of early atherosclerotic and cardiac damage in patients undergoing liver transplantation: Preliminary results",
abstract = "Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.",
keywords = "Carotid IMT, EAT, OLT, Visceral adiposity atherosclerosis",
author = "Giuseppina Pisano and Donato, {Maria Francesca} and Dario Consonni and Giovanna Oberti and Vittorio Borroni and Rosa Lombardi and Federica Invernizzi and Cristina Bertelli and Lucio Caccamo and Marianna Porzio and Daniele Dondossola and Giorgio Rossi and Silvia Fargion and Fracanzani, {Anna Ludovica}",
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TY - JOUR

T1 - High prevalence of early atherosclerotic and cardiac damage in patients undergoing liver transplantation

T2 - Preliminary results

AU - Pisano, Giuseppina

AU - Donato, Maria Francesca

AU - Consonni, Dario

AU - Oberti, Giovanna

AU - Borroni, Vittorio

AU - Lombardi, Rosa

AU - Invernizzi, Federica

AU - Bertelli, Cristina

AU - Caccamo, Lucio

AU - Porzio, Marianna

AU - Dondossola, Daniele

AU - Rossi, Giorgio

AU - Fargion, Silvia

AU - Fracanzani, Anna Ludovica

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.

AB - Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p = 0.001) and worsening of carotid damage (p = 0.003) and diastolic dysfunction (E/A p = 0.001) was observed at 6 months after transplant and remained stable at 24 months, corresponding to an increased prevalence of diabetes, metabolic syndrome, hypertension and dyslipidemia. The duration of steroid therapy, withdrawn in the majority of patients at 3 months, did not influence cardiovascular damage. No significant difference in early progression of cardiovascular damage was observed between patients who did or did not receive a graft with steatosis. Conclusion: The occurrence of early cardiovascular alterations in the first 6 months after OLT accounts for the reported cardiovascular events in the first years after transplant. In light of these results, new strategies aimed at preventing or delaying cardiovascular alterations should be provided, starting from the first weeks after transplant.

KW - Carotid IMT

KW - EAT

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KW - Visceral adiposity atherosclerosis

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