Journal List > J Korean Soc Transplant > v.25(4) > 1034348

J Korean Soc Transplant. 2011 Dec;25(4):229-238. Korean.
Published online December 31, 2011.  https://doi.org/10.4285/jkstn.2011.25.4.229
Copyright © 2011 The Korean Society for Transplantation
Cardiovascular Diseases after Solid Organ Transplantation
Jae-Joong Kim, Ph.D.
Department of Internal Medicine, Asan Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author (Email: jjkim@amc.seoul.kr )
Received November 30, 2011; Accepted November 30, 2011.

Abstract

Despite recent advances in the prolongation of patient and graft survival, transplant patients continue to die prematurely of cardiovascular disease. Cardiovascular disease after solid organ transplantation is a serious complication caused by numerous factors, most shared with the general population and others specific to transplant recipients including immunosuppressive drugs and renal dysfunction. Among traditional risk factors in general population, hypertension, dyslipidemia and diabetes are more common in solid organ transplant recipients. The control of risk factors is more difficult in transplant recipients than in general population. Immunosuppressive drugs are related to hypertension, dyslipidemia and posttransplant DM. Reduction of immunosuppression is helpful to reduce the risk of cardiovascular disease but may increase the risk of rejection and graft loss. mTOR inhibitor has less potential risk to develop cardiovascular disease. Future development of new immunosuppressive drug with less potential risk of CV disease but same efficacy to prevent rejection and graft loss will be a promising goal to prevent CV disease. In conclusion, multidisciplinary approach that emphasizes evidence-based management of traditional risk factors and development of new immunosuppressive drugs are the best approach to reducing the risk of CV disease after solid organ transplantation.

Keywords: Solid organ transplantation; Cardiovascular diseases; Risk factors

Tables


Table 1
Prevalence of new posttransplant cardiovascular events
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Table 2
Cardiovascular risk factors in general population
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Table 3
Cardiovascular risk factors in renal transplant recipients and relative risks
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Table 4
Prevalence of traditional cardiovascular risk factors in ESRD patients groups (%)
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Table 5
Mechanisms that contribute to posttransplant hypertension
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Table 6
Different mechanisms of calcineurin inhibitor induced rise of BP
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Table 7
Antihypertensive medications commonly used in transplant recipients and their potential adverse effects
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Table 8
Treatment guidelines for posttransplant dyslipidemia
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Table 9
Effects of immunosuppressive agents on cardiovascular risks
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Table 10
Control of cardiovascular risk factors
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