title: Metabolic syndrome in liver transplantation: A preoperative and postoperative concern.
abstract: Metabolic syndrome is increasing among patients undergoing liver transplantation. Nonalcoholic steatohepatitis is a manifestation of metabolic syndrome and is an increasingly common cause of end-stage liver disease necessitating orthotopic liver transplantation. We sought to determine the effect of preoperative risk factors on the development of post-transplant metabolic syndrome, complications, readmissions, and mortality.
  
  
  
  We conducted a review of 114 orthotopic liver transplantations at our institution from May 2012 to April 2014.
  
  
  
  Patients with (n = 19) and without (n = 95) metabolic syndrome were similar with regard to age, race, and model for end-stage liver disease at time of transplant. Donor and operative factors also were similar between the groups. Preoperative diabetes was found to be associated with an increased rate of readmission (odds ratio 3.45, P = .03). While preoperative metabolic syndrome itself was not a significant predictor of worse outcomes, postoperative metabolic syndrome was associated with significantly greater readmissions in the first year. Major predictors of new onset metabolic syndrome after orthotopic liver transplantation included preoperative diabetes and obesity (odds ratio 8.54 and odds ratio 5.49, P < .01 each).
  
  
  
  Efforts to decrease the incidence of postoperative metabolic syndrome after orthotopic liver transplantation may decrease readmissions and improve outcomes, along with decreasing resource utilization.
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Alex L
authors: AL
authors: Chang
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Alexander R
authors: AR
authors: Cortez
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Alexander
authors: A
authors: Bondoc
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Daniel P
authors: DP
authors: Schauer
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Angela
authors: A
authors: Fitch
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Shimul A
authors: SA
authors: Shah
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH.
authors: Steve E
authors: SE
authors: Woodle
authors: Department of Surgery, Division of Transplantation, CCORE (Cincinnati Collaborative for Obesity Research), University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: diwantb@ucmail.uc.edu.
authors: Tayyab
authors: T
authors: Diwan
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D016208:Databases, Factual; D058625:End Stage Liver Disease / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome