title: Medical Management of Metabolic Complications of Liver Transplant Recipients.
abstract: Improved short- and long-term survival of liver transplant recipients has led to increased focus on complications of both the early and late posttransplant periods. A variety of metabolic complications have been observed in the post-orthotopic liver transplant population, including hypertension, hyperlipidemia, obesity, diabetes mellitus, nonalcoholic fatty liver disease, and nonalcoholic steatohepatitis. Although only a small proportion of patients experience metabolic complications prior to transplantation, the prevalence of these complications posttransplantation reaches or exceeds that of the general population. This is of particular concern, as cardiovascular disease is the second leading cause of death in the late transplant period. A number of mechanisms mediate these metabolic complications, including reversal of cirrhosis pathophysiology, patient lifestyle factors, and immunosuppressive medications. Titration and modification of immunosuppression have been demonstrated to improve and sometimes even eliminate these conditions. Therefore, given the multiple etiologies contributing to the metabolic derangements, an effective management approach must incorporate lifestyle modifications, immunosuppression titration, and medical management. Best practices and understanding of the mechanisms underlying these complications allow for discussion of initial therapies and strategies; however, further study is necessary to determine the optimal management of metabolic complications over time.
authors.affiliation: Dr Barnard is a resident physician in the Department of Internal Medicine at the University of California, Los Angeles in Los Angeles, California. Mr Konyn is a medical student at the David Geffen School of Medicine at the University of California, Los Angeles. Dr Saab is a professor in the Departments of Internal Medicine and Surgery at the University of California, Los Angeles.
authors.forename: Abbey
authors.initials: A
authors.lastname: Barnard
authors.affiliation: Dr Barnard is a resident physician in the Department of Internal Medicine at the University of California, Los Angeles in Los Angeles, California. Mr Konyn is a medical student at the David Geffen School of Medicine at the University of California, Los Angeles. Dr Saab is a professor in the Departments of Internal Medicine and Surgery at the University of California, Los Angeles.
authors.forename: Peter
authors.initials: P
authors.lastname: Konyn
authors.affiliation: Dr Barnard is a resident physician in the Department of Internal Medicine at the University of California, Los Angeles in Los Angeles, California. Mr Konyn is a medical student at the David Geffen School of Medicine at the University of California, Los Angeles. Dr Saab is a professor in the Departments of Internal Medicine and Surgery at the University of California, Los Angeles.
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
keywords: Liver transplant; long-term care; medical management; metabolic complications