Metabolic Complications and Associated Cardiovascular Disease Risk Post Liver Transplant

Abstract

Purpose: The purpose of this Doctor of Nursing Practice study was to investigate the prevalence of metabolic complications as well as recurrent or new-onset non-alcoholic fatty liver disease (NAFLD) and associated cardiovascular disease risk among liver transplant recipients. Design: Retrospective, descriptive. Setting: Local transplant program in San Antonio, Texas. Sample: 41 liver transplant recipients transplanted between July 2016 and June 2017. Methods: A health care record review using a data collection instrument created to profile cardiovascular disease risk up to one-year post-transplant. Main Research Variables: Cardiovascular disease risk factors including blood pressure (BP), hemoglobin A1C, low-density lipoprotein, and body mass index, as well as NAFLD. Additional Research Variables: Variables influencing NAFLD and cardiovascular disease risk such as etiology of liver disease, ethnicity, age, gender, family history, and immunosuppression medications. Findings: Most data on metabolic complications and cardiovascular disease risk factors such as dyslipidemia and diabetes mellitus were not documented. Hypertension was prevalent at one-year post-transplant, and BPs were sub-optimally managed. New-onset or recurrent NAFLD following transplant only occurred in 12% of the sample. There were no documented cardiovascular disease related events within the first year following transplant. Conclusions: Prevalence of metabolic complications as well as NAFLD among liver transplant recipients is important in the evaluation of cardiovascular disease risk to reduce related events and mortality following transplant but not commonly documented by the local transplant program. Improved documentation and communication between Hepatology specialists and primary care providers is necessary for early recognition and appropriate medical management of post-transplant metabolic complications. Better control of BP may help reduce cardiovascular disease risk in the late post-transplant period. Prospective studies with larger sample sizes are needed to further investigate the prevalence of metabolic complications as well as NAFLD and associated cardiovascular disease risk among liver transplant recipients.