title: Accelerated atherosclerosis and elevated lipoprotein (a) after liver transplantation.
abstract: Cumulative evidence suggests that lipoprotein(a) [Lp(a)] exerts an independent effect on the initiation and progression of atherosclerotic cardiovascular disease. The genetically mediated expression of apolipoprotein(a), which is the key structural and functional component of Lp(a), occurs in hepatocytes with subsequent extracellular Lp(a) assembly at the hepatic cell surface. Here, we describe a case of elevated Lp(a) concentrations identified after (and likely acquired by) orthotopic liver transplantation that contributed to accelerated atherosclerotic cardiovascular disease despite intensive therapeutic interventions. This case study represents an important example to include Lp(a) screening in routine lipid panel testing for all liver transplant donors and recipients; to reduce unanticipated and debilitating cardiovascular morbidity and mortality.
authors.affiliation: Cardiovascular Division and Elaine and Sydney Sussman Cardiac Catheterization Laboratories, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Abdulla A
authors.initials: AA
authors.lastname: Damluji
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, University of Miami, Miller School of Medicine, Miami, FL, USA; National Institutes of Health, Bethesda, MD, USA.
authors.forename: Diala
authors.initials: D
authors.lastname: El-Maouche
authors.affiliation: Cardiovascular Division and Elaine and Sydney Sussman Cardiac Catheterization Laboratories, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Alsulaimi
authors.affiliation: Division of Hepatology, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Martin
authors.affiliation: National Institutes of Health, Bethesda, MD, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Shamburek
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Goldberg
authors.affiliation: Cardiovascular Division and Elaine and Sydney Sussman Cardiac Catheterization Laboratories, University of Miami, Miller School of Medicine, Miami, FL, USA.
authors.forename: Seth J
authors.initials: SJ
authors.lastname: Baum
authors.affiliation: Cardiovascular Division and Elaine and Sydney Sussman Cardiac Catheterization Laboratories, University of Miami, Miller School of Medicine, Miami, FL, USA. Electronic address: emarchen@med.miami.edu.
authors.forename: Eduardo J
authors.initials: EJ
authors.lastname: de Marchena
mesh_terms: D050197:Atherosclerosis / Q000097:blood* / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence
chemical_list: D017270:Lipoprotein(a)
keywords: Cardiovascular disease; Lipids; Lp(a); Prevention; Therapy