Prevalence and Predictors of Metabolic Syndrome After Liver Transplantation.

BACKGROUND: The development of metabolic syndrome (MS) after liver transplantation (LT) is a major source of mortality derived from cardiovascular events. The aim of the present study was to determine the prevalence and risk factors of MS after LT. METHODS: One-hundred seventy-four consecutive LT patients from January 2004 to June 2010 surviving longer than 1 year after LT were included. Median follow-up after LT was 48 months. Independent predictors of MS were obtained by means of multivariate logistic regression. RESULTS: At 3 years after LT, 25.5% of patients reached a body mass index (BMI) ≥30 kg/m2, 35.6% of patients developed arterial hypertension, 54.2% showed impaired fasting glucose, 22.5% had serum cholesterol >200 mg/dL, and 22.5% showed hypertriglyceridemia >150 mg/dL. The prevalence of MS ranged from 49% to 86% depending on the considered period. The pre-LT variables associated with MS were age at LT (odds ratio [OR], 1.08; P = .002), BMI of recipient before LT (OR, 1.23; P = .001), serum glucose (OR, 1.02; P = .005), and non-heart-beating donor (OR, 1.02; P = .046). The post-LT predictors of MS were body weight (OR, 1.04; P = .005), arterial hypertension (OR, 1.02; P = .047), and serum glucose (OR, 1.02; P = .011) at 6 months. CONCLUSIONS: LT patients develop MS in a high proportion and progressively despite current efforts (ie, lifestyle modifications and aggressive management of hypertension, diabetes, and hyperlipidemia). The associated risk factors include age, increased BMI, and pre- and post-LT glucose.

Obstrucción biliar por adenocarcinoma de la papila de Vater en un paciente con trasplante hepático ortotópico / Biliary obstruction due to adenocarcinoma of the ampulla of Vater ten years after orthotopic liver transplantation

Las principales causas de mortalidad en trasplantados hepáticos son las derivadas del propio injerto. Dado el aumento de la supervivencia de este grupo de pacientes, está aumentando los casos de neoplasias de novo en otras localizaciones.Se presenta el caso de un varón de 60 años, trasplantado hepático ortotópico hace 10 años por cirrosis terminal causada por virus de la hepatitis B. Los estudios radiológicos realizados demostraron dilatación de la vía biliar intra y extrahepática, sin que hubiera evidencia de litiasis, estenosis anastomótica ni otras complicaciones biliares usuales en trasplantados hepáticos. El diagnóstico definitivo se hizo con colangiopancreatografía retrógrada endoscópica.El adenocarcinoma de la papila de Vater es una causa de obstrucción biliar que se debe considerar en pacientes con trasplante hepático ortotópico (AU)

The main causes of death in patients with liver transplants are derived from the graft itself. Given the increased survival in this group of patients, the rate of de novo neoplasms in other locations is increasing. We present the case of a 60-year-old man who underwent orthotopic liver transplantation 10 years earlier for terminal cirrhosis caused by hepatitis B. Imaging studies showed dilation of the intra- and extra-hepatic bile ducts with no evidence of lithiasis, anastomotic stenosis, or other biliary complications that are common in patients with liver transplants. The definitive diagnosis was reached by endoscopic retrograde cholangio pancreatography. Adenocarcinoma of the ampulla of Vater should be considered among the causes of biliary obstruction in patients with orthotopic liver transplants (AU)

[Biliary obstruction due to adenocarcinoma of the ampulla of Vater ten years after orthotopic liver transplantation]. / Obstrucción biliar por adenocarcinoma de la papila de Vater en un paciente con trasplante hepático ortotópico.

The main causes of death in patients with liver transplants are derived from the graft itself. Given the increased survival in this group of patients, the rate of de novo neoplasms in other locations is increasing. We present the case of a 60-year-old man who underwent orthotopic liver transplantation 10 years earlier for terminal cirrhosis caused by hepatitis B. Imaging studies showed dilation of the intra- and extra-hepatic bile ducts with no evidence of lithiasis, anastomotic stenosis, or other biliary complications that are common in patients with liver transplants. The definitive diagnosis was reached by endoscopic retrograde cholangiopancreatography. Adenocarcinoma of the ampulla of Vater should be considered among the causes of biliary obstruction in patients with orthotopic liver transplants.