Journal of Gastroenterology

, Volume 42, Issue 9, pp 769–774

Hyperlipidemia in Iranian liver transplant recipients: prevalence and risk factors

  • Seyed Mohsen Dehghani
  • Seyed Ali Reza Taghavi
  • Ahad Eshraghian
  • Siavash Gholami
  • Mohammad Hadi Imanieh
  • Mohammad Reza Bordbar
  • Seyed Ali Malek-Hosseini
Liver, Pancreas, and Biliary Tract



Hyperlipidemia is a metabolic complication after liver transplantation (LT). The aim of this study was to investigate the prevalence and risk factors for developing hyperlipidemia in patients who underwent LT in the Shiraz Organ Transplantation Center.


Our patients were 170 liver recipients who underwent LT from 1994 to 2006 in the Organ Transplantation Center of the Shiraz University of Medical Sciences. To perform this study we administered questionnaires, including information about age, sex, body mass index (BMI), underlying liver disease, graft type, immunosuppressive medications, and serum levels of triglycerides and cholesterol, before and 6 months after LT. Serum triglyceride and cholesterol levels were considered elevated if they were >150 mg/dl and >250 mg/dl, respectively. Data were analyzed with SPSS software.


There were 108 male and 62 female patients, with a mean age of 31.4 ± 13.3 years, and the mean duration of follow-up was 25.9 ± 23.5 months. The average pretransplant serum triglyceride and cholesterol (mean of individual means) levels were 104.6 ± 73.2 and 109.5 ± 51.5 mg/dl, respectively, and the average posttransplant levels were 230.1 ± 131 and 185 ± 77 mg/dl, respectively. Six months after LT, 119 (70%) and 26 (15.3%) patients developed hypertriglyceridemia and hypercholesterolemia, respectively. Age, sex, BMI, and underlying liver disease were not predictors of hypertriglyceridemia or hypercholesterolemia (P > 0.05). Posttransplant hypertriglyceridemia was significantly more common in patients receiving tacrolimus than in those receiving cyclosporine (P = 0.040), but posttransplant hypercholesterolemia had no significant correlation with type of immune suppression (P > 0.05).


Hyperlipidemia was common after LT, and hypertriglyceridemia was more common than hypercholesterolemia. Among all risk factors, tacrolimus therapy was correlated with development of hypertriglyceridemia after LT.

Key words

liver transplantation hyperlipidemia prevalence risk factors 


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  1. 1.
    Munoz, SJ, Deems, RO, Moritz, MJ, Martin, P, Jarrell, BE, Maddrey, WC 1991Hyperlipidemia and obesity after orthotopic liver transplantationTransplant Proc2314803PubMedGoogle Scholar
  2. 2.
    Jindal, RM, Popescu, I, Emre, S, Schwartz, ME, Boccagni, P, Meneses, P,  et al. 1994Serum lipid changes in liver transplant recipients in a prospective trial of cyclosporine versus FK506Transplantation5713958PubMedCrossRefGoogle Scholar
  3. 3.
    Imagawa, DK, Dawson, S, Holt, CD, Kirk, PS, Kaldas, FM, Shackleton, CR,  et al. 1996Hyperlipidemia after liver transplantation: natural history and treatment with the hydroxy-methylglutaryl-coenzyme A reductase inhibitor pravastatinTransplantation6293442PubMedCrossRefGoogle Scholar
  4. 4.
    Kobashigawa, JA, Kasiske, BL 1997Hyperlipidemia in solid organ transplantationTransplantation633318PubMedCrossRefGoogle Scholar
  5. 5.
    Johnston, SD, Morris, JK, Cramb, R, Gunson, BK, Neuberger, J 2002Cardiovascular morbidity and mortality after orthotopic liver transplantationTransplantation739016PubMedCrossRefGoogle Scholar
  6. 6.
    Guckelberger, O, Bechstein, WO, Neuhaus, R, Luesebrink, R, Lemmens, HP, Kratschmer, B,  et al. 1997Cardiovascular risk factors in long-term follow-up after orthotopic liver transplantationClin Transpl11605Google Scholar
  7. 7.
    Pratschke, J, Neuhaus, R, Tullius, SG, Haller, GW, Jonas, S, Steinmueller, T,  et al. 1997Treatment of cyclosporine-related adverse effects by conversion to tacrolimus after liver transplantationTransplantation6493840PubMedCrossRefGoogle Scholar
  8. 8.
    Neal, DA, Gimson, AE, Gibbs, P, Alexander, GJ 2001Beneficial effects of converting liver transplant recipients from cyclosporine to tacrolimus on blood pressure, serum lipids, and weightLiver Transpl75339PubMedCrossRefGoogle Scholar
  9. 9.
    Manzarbeitia, C, Reich, DJ, Rothstein, KD, Braitman, LE, Levin, S, Munoz, SJ 2001Tacrolimus conversion improves hyperlipidemic states in stable liver transplant recipientsLiver Transpl7939PubMedCrossRefGoogle Scholar
  10. 10.
    Siirtola, A, Antikainen, M, Ala-Houhala, M, Koivisto, AM, Solakivi, T, Virtanen, SM,  et al. 2005Insulin resistance, LDL particle size, and LDL susceptibility to oxidation in pediatric kidney and liver recipientsKidney Int67204655PubMedCrossRefGoogle Scholar
  11. 11.
    Hyams, JS, Treem, WR, Andrews, WS, Herbert, PN 1989Lipid abnormalities in pediatric hepatic allograft recipientsJ Pediatr Gastroenterol Nutr94414PubMedCrossRefGoogle Scholar
  12. 12.
    Kanbay, M, Yildirir, A, Akcay, A, Colak, T, Ozdemir, FN, Muderrisoglu, H,  et al. 2006Effects of immunosuppressive drugs on serum lipid levels in renal transplant recipientsTransplant Proc385025PubMedCrossRefGoogle Scholar
  13. 13.
    Granot, E 1998Lipoprotein changes in children after liver transplantation: mild hypertriglyceridemia and a decrease in HDL3/HDL2 ratioHepatology2717580PubMedCrossRefGoogle Scholar
  14. 14.
    Siirtola, A, Ketomaki, A, Miettinen, TA, Gylling, H, Lehtimaki, T, Holmberg, C,  et al. 2006Cholesterol absorption and synthesis in pediatric kidney, liver, and heart transplant recipientsTransplantation8132734PubMedCrossRefGoogle Scholar
  15. 15.
    Quaschning, T, Mainka, T, Nauck, M, Rump, LC, Wanner, C, Kramer-Guth, A 1999Immunosuppression enhances atherogenicity of lipid profile after transplantationKidney Int71S2357CrossRefGoogle Scholar
  16. 16.
    Cofan, F, Cofan, M, Campos, B, Guerra, R, Campistol, JM, Oppenheimer, F 2005Effect of calcineurin inhibitors on low-density lipoprotein oxidationTransplant Proc3737913PubMedCrossRefGoogle Scholar
  17. 17.
    Devaraj, S, Li, DJ, Vazquez, M, Jialal, I 1999Cyclosporine A does not increase the oxidative susceptibility of low density lipoprotein in vitroFree Radic Biol Med2610648PubMedCrossRefGoogle Scholar
  18. 18.
    Hohage, H, Welling, U, Heck, M, Zeh, M, Gerhardt, U, Suwelack, BM 2005Conversion from cyclosporine to tacrolimus after renal transplantation improves cardiovascular risk factorsInt Immunopharmacol511723PubMedCrossRefGoogle Scholar
  19. 19.
    Gisbert, C, Prieto, M, Berenguer, M, Breto, M, Carrasco, D, de Juan, M,  et al. 1997Hyperlipidemia in liver transplant recipients: prevalence and risk factorsLiver Transpl Surg341622PubMedCrossRefGoogle Scholar
  20. 20.
    Mathe, D, Adam, R, Malmendier, C, Gigou, M, Lontie, JF, Dubois, D,  et al. 1992Prevalence of dyslipidemia in liver transplant recipientsTransplantation5416770PubMedGoogle Scholar
  21. 21.
    Jindal, RM, Sidner, RA, Hughes, D, Pescovitz, MD, Leapman, SB, Milgrom, ML,  et al. 1996Metabolic problems in recipients of liver transplantsClin Transplant102137PubMedGoogle Scholar
  22. 22.
    Stegall, MD, Everson, G, Schroter, G, Bilir, B, Karrer, F, Kam, I 1995Metabolic complications after liver transplantation. Diabetes, hypercholesterolemia, hypertension, and obesityTransplantation60105760PubMedGoogle Scholar
  23. 23.
    Charco, R, Cantarell, C, Vargas, V, Capdevila, L, Lazaro, JL, Hidalgo, E,  et al. 1999Serum cholesterol changes in long-term survivors of liver transplantation: a comparison between cyclosporine and tacrolimus therapyLiver Transpl Surg52048PubMedCrossRefGoogle Scholar
  24. 24.
    Rabkin, JM, de La Melena, V, Orloff, SL, Corless, CL, Rosen, HR, Olyaei, AJ 2001Late mortality after orthotopic liver transplantationAm J Surg1814759PubMedCrossRefGoogle Scholar
  25. 25.
    Fernandez-Miranda, C, De la Calle, A, Loinaz, C, Moreno, E 1999Hyperlipidemia in liver transplanted patientsRev Esp Enferm Dig916459PubMedGoogle Scholar
  26. 26.
    Kniepeiss, D, Iberer, F, Schaffellner, S, Jakoby, E, Duller, D, Kh, Tscheliessnigg 2004Dyslipidemia during sirolimus therapy in patients after liver transplantationClin Transplant186426PubMedCrossRefGoogle Scholar
  27. 27.
    Roy, A, Kneteman, N, Lilly, L, Marotta, P, Peltekian, K, Scudamore, C,  et al. 2006Tacrolimus as intervention in the treatment of hyperlipidemia after liver transplantTransplantation82494500PubMedCrossRefGoogle Scholar
  28. 28.
    Fellstrom, B 2000Impact and management of hyperlipidemia posttransplantationTransplantation70S517Google Scholar

Copyright information

© Springer-Verlag Tokyo 2007

Authors and Affiliations

  • Seyed Mohsen Dehghani
    • 1
    • 2
    • 3
  • Seyed Ali Reza Taghavi
    • 1
    • 2
  • Ahad Eshraghian
    • 2
  • Siavash Gholami
    • 1
  • Mohammad Hadi Imanieh
    • 1
    • 2
  • Mohammad Reza Bordbar
    • 3
  • Seyed Ali Malek-Hosseini
    • 1
  1. 1.Organ Transplantation CenterNemazee Hospital, Shiraz University of Medical SciencesShirazIran
  2. 2.Pediatric Office, Gastroenterohepatology Research CenterNemazee Hospital, Shiraz University of Medical SciencesShirazIran
  3. 3.Department of PediatricsShiraz University of Medical SciencesShirazIran

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