Long-term Management of the Adult Liver Transplantation Recipients

Abstract

The survival of liver transplantation (LT) recipients has been improved remarkably in short-term. The major causes of mortality in long-term include nonimmunological causes such as cardiovascular, de novo malignancy, chronic kidney disease, and recurrence of primary disease. Rejection-related mortality is rare in the long-term after LT. We discuss nonrejection causes of long-term morbidity/mortality, risk factors, and management strategies in LT recipients. In addition, we discuss osteoporosis, contraception, and pregnancy in LT recipients.

Keywords: AIH, autoimmune hepatitis; BMI, body mass index; CKD, chronic kidney disease; CNI, calcineurin inhibitors; CVD, cardiovascular disease; DDLT, deceased donor liver transplantation; DM, diabetes mellitus; DNM, de novo malignancy; HCV, hepatitis C virus; HR, hazard ratio; IUCD, Intrauterine contraceptive devices; LDLT, living donor liver transplantation; LT, liver transplantation; MDRD, Modification of Diet in Renal Disease; MMF, mycophenolate; MS, metabolic syndrome; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; OR, odds ratio; PBC, primary biliary cholangitis; PSC, primary sclerosing cholangitis; PTDM, posttransplantation diabetes mellitus; PTMS, posttransplantation metabolic syndrome; SVR, sustained virological response; cardiovascular disease; de novo malignancy; eGFR, estimated glomerular filtration rate; mTORi, Mammalian target of rapamycin inhibitors; osteoporosis; pregnancy; recurrence.