Cardiovascular risk 10 years after liver transplant

Exp Clin Transplant. 2014 Feb;12(1):55-61. doi: 10.6002/ect.2013.0208.

Abstract

Objectives: We sought to evaluate the frequency of cardiovascular risk factors in a cohort of patients 10 years after a liver transplant, and to assess their 10-year risk of fatal cardiovascular disease using Systematic COronary Risk Evaluation (SCORE) charts.

Materials and methods: Between January 1990 and June 1996, one hundred eighty-nine adults underwent a first liver transplant in our center. Fifty-nine patients (31%) died before reaching their tenth year, and 115 patients were available with complete clinical data at 10 years.

Results: The main indications for liver transplant were alcoholic (38%) and viral cirrhosis (40%). The median age of patients was 56 (range, 29-73 y), 80% were men, 23% were obese, 16% were active smokers, 18% were diabetic, 40% had hypercholesterolemia, and 77% had hypertension. Before the tenth year after transplant, 6 deaths were because of cardiovascular diseases, which represents the third cause of late death (> 1 year after liver transplant). After liver transplant, 5% of the surviving patients underwent ischemic cardiovascular events during the first decade. At a 10-year assessment, the median estimated 10-year risk of fatal cardiovascular disease was 1% (range, 0%-9%) and 10% of the patients had a high risk (ie, SCORE ≥ 5%).

Conclusions: Our results suggest that the frequency of cardiovascular events is relatively low after a liver transplant, even if most of the patients had 1 or more cardiovascular risk factors. Nevertheless, clinicians should perform a similar evaluation 15 or 20 years after the liver transplant because cardiovascular risk exponentially increases with age.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / mortality
  • Female
  • France / epidemiology
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / mortality
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Transplant Recipients*
  • Treatment Outcome