Semin Liver Dis 2009; 29(1): 102-120
DOI: 10.1055/s-0029-1192059
© Thieme Medical Publishers

Long-Term Care of the Liver Allograft Recipient

George Mells1 , James Neuberger2
  • 1The Liver Unit, Addenbrooke's Hospital, Cambridge, United Kingdom
  • 2The Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom
Further Information

Publication History

Publication Date:
23 February 2009 (online)

ABSTRACT

As outcomes after liver transplant surgery continue to improve, management of the long-term consequences of the procedure and the associated immunosuppression become increasingly important. Liver allograft recipients have, compared with age and sex-matched controls, increased risk for cardiovascular and cerebrovascular events and death, for bone disease, and for some cancers. Early recognition and treatment of modifiable risk factors, especially of hypertension (present in up to 77% recipients), diabetes (in up to 22%), obesity (up to 40%), renal impairment (in up to 50%), and hyperlipidemia (in up to 66%) are necessary to maintain prolonged and healthy survival. Early recognition of de novo cancers (which occur in up to 26% recipients) indicates the need for additional monitoring for skin cancer and lymphoproliferative disorders, as well as cancers of the lung, colon, and upper gastrointestinal track. Early recognition of bone disease and appropriate intervention will allow introduction of strategies to reduce bone fracture. In this article, we review the evidence for the extent and treatment of these modifiable conditions in the allograft recipient.

REFERENCES

James Neuberger, M.D. 

The Liver Unit, Queen Elizabeth Hospital

Birmingham B15 2TH, United Kingdom

Email: J.M.Neuberger@bham.ac.uk