Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2012; 18(28): 3627-3634
Published online Jul 28, 2012. doi: 10.3748/wjg.v18.i28.3627
Metabolic syndrome after liver transplantation: Preventable illness or common consequence?
Eric R Kallwitz
Eric R Kallwitz, Section of Hepatology, University of Illinois, Chicago, IL 60612, United States
Author contributions: Kallwitz ER was responsible for conception, drafting and final approval of the article.
Correspondence to: Eric R Kallwitz, Assistant Professor of Medicine, Section of Hepatology, University of Illinois, 840 S Wood Street MC 787, Chicago, IL 60612, United States. kallwitz@uic.edu
Telephone: +1-312-3555365 Fax: +1-312-4132844
Received: May 7, 2012
Revised: June 25, 2012
Accepted: June 28, 2012
Published online: July 28, 2012
Abstract

The metabolic syndrome is common after liver transplant being present in approximately half of recipients. It has been associated with adverse outcomes such as progression of hepatitis C and major vascular events. As the United States population ages and the rate of obesity increases, prevention of the metabolic syndrome in the post-transplant population deserves special consideration. Currently, the metabolic syndrome after transplant appears at least two times more common than observed rates in the general population. Specific guidelines for patients after transplant does not exist, therefore prevention rests upon knowledge of risk factors and the presence of modifiable elements. The current article will focus on risk factors for the development of the metabolic syndrome after transplant, will highlight potentially modifiable factors and propose potential areas for intervention. As in the non-transplant population, behavioral choices might have a major role. Opportunities exist in this regard for health prevention studies incorporating lifestyle changes. Other factors such as the need for immunosuppression, and the changing characteristics of wait listed patients are not modifiable, but are important to know in order to identify persons at higher risk. Although immunosuppression after transplant is unavoidable, the contribution of different agents to the development of components of the metabolic syndrome is also discussed. Ultimately, an increased risk of the metabolic syndrome after transplant is likely unavoidable, however, there are many opportunities to reduce the prevalence.

Keywords: Liver transplantation; Diabetes mellitus; Dyslipidemias; Hypertension; Metabolic syndrome X; Obesity; Hypertension; Immunosuppression