Major influence of renal function on hyperlipidemia after living donor liver transplantation

Table 1 Patients’ characteristics in post-transplant hyperlipidemia group and non post-transplant hyperlipidemia group (means ± SD)

	PTHL group(n = 28)	Non-PTHL group (n = 87)	P value
Donor
Age (yr)	24.8 ± 4.3	24.0 ± 6.4	NS
Male/female (n)	27/1	80/7	NS
Cold ischemia time (h)	1.2 ± 0.5	1.1 ± 0.4	NS
GR/WR (%)	1.0 ± 0.2	1.1 ± 0.2	0.048
GV/SLV (%)	58.5 ± 5.6	62.6 ± 10.7	0.011
Hepatic steatosis n (%)	2 (7.1)	7 (8.0)	NS
Serum triglyceride (mg/dL)	90.9 ± 42.4	96.2 ± 45.0	NS
Serum cholesterol (mg/dL)	137.3 ± 30.9	135.7 ± 27.1	NS
Recipient
Age (yr)	45.4 ± 8.2	44.5 ± 10.6	NS
Male/female (n)	27/1	69/18	NS
Primary liver diseases n (%)
Cirrhosis	12 (42.9)	51 (58.6)	NS
Acute liver failure	9 (32.1)	19 (21.8)	NS
Hepatocellular carcinoma	7 (25)	17 (19.5)	NS
Pre-transplant metabolic status
BMI (kg/m2)	23.2 ± 3.16	21.9 ± 2.79	0.036
Smoking n (%)	7 (25)	19 (21.8)	NS
Alcohol abuse n (%)	3 (10.7)	13 (14.9)	NS
Diabetes mellitus n (%)	2 (7.1)	4 (4.6)	NS
Hypertension n (%)	3 (10.7)	5 (5.7)	NS
Hyperlipidemia n (%)	4 (14.3)	15 (17.2)	NS
Pre-transplant MELD score	23.8 ± 12.4	20.1 ± 9.6	NS
Total bilirubin (mg/dL)	14.2 (1.0-36.5)	12.8 (0.8-33.6)	NS
International normalized ratio	1.6 ± 1.1	1.4 ± 0.6	NS
Serum creatinine (mg/dL)	0.9 (0.5-4.0)	0.7 (0.4-4.5)	0.004
Post-transplant tacrolimus level (ng/mL)
Month 1	8.1 ± 2.8	9.8 ± 4.6	NS
Month 3	9.2 ± 2.6	8.3 ± 2.6	NS
Month 6	6.7 ± 2.2	7.7 ± 2.7	NS
Follow-up period (yr)	2.7 ± 1.2	2.6 ± 0.9	NS

PTHL: Post-transplant hyperlipidemia; GR/WR: Graft-to-recipient weight ratio; GV/SLV: Graft volume/standard liver volume; BMI: Body mass index; MELD: Model for end-stage liver disease; NS: Not significant.

Table 2 Comparison between patients with and without early renal dysfunction (means ± SD)

	ERD(n = 16)	Non-ERD(n = 99)	P value
Pre-transplant
MELD	30.1 ± 11.7	19.5 ± 9.4	< 0.001
Total bilirubin (mg/dL)	15.2 (1.8-29.8)	13.6 (0.8-36.5)	NS
International normalized ratio	1.6 ± 0.9	1.4 ± 0.7	NS
Serum creatinine (mg/dL)	2.2 (0.7-4.0)	0.8 (0.5-4.5)	< 0.001
Renal insufficiency > 15 d n (%)	11 (68.8)	15 (15.2)	< 0.001
Hemodialysis n (%)	11 (68.8)	5 (5.1)	< 0.001
Serum triglyceride (mg/dL)	77.7 ± 58.4	77.7 ± 62.7	NS
Serum cholesterol (mg/dL)	92.7 ± 42.9	119.3 ± 55.6	NS
Post-transplant
Serum creatinine (mg/dL)
At month 1	1.4 (0.6-2.8)	0.7 (0.2-1.2)	< 0.001
At month 3	1.0 (0.6-3.0)	0.7 (0.3-1.3)	0.008
At month 6	1.1 (0.6-4.1)	0.7 (0.3-1.5)	< 0.001
Total bilirubin (mg/dL)
At month 1	1.3 (0.4-4.3)	1.1 (0.3-5.8)	NS
At month 3	0.6 (0.2-2.5)	0.7 (0.3-2.5)	NS
At month 6	0.6 (0.3-2.0)	0.8 (0.4-2.8)	NS
Cholinesterase (U/L)
At month 1	3681.3 ± 1354.3	4403.9 ± 1323.6	NS
At month 3	5996.7 ± 1619.4	6830.7 ± 1750.5	NS
At month 6	7255.4 ± 1662.9	7171.5 ± 1721.6	NS
Hypertriglyceridemia n (%)	9 (56.3)	12 (12.1)	< 0.001
Hypercholesterolemia n (%)	3 (18.8)	9 (9.1)	NS
PTHL n (%)	9 (56.3)	19 (19.2)	0.003

Hypertriglyceridemia was defined as serum triglycerides ≥ 150 mg/dL; Hypercholesterolemia was defined as serum cholesterol ≥ 200mg/dL. PTHL: Post-transplant hyperlipidemia; MELD: Model for end-stage of liver disease; ERD: Early renal dysfunction; NS: Not significant.

Table 3 Logistic regression analysis of variables relating to post-transplant hyperlipidemia

		Univariate analysis		Multivariate analysis
		OR (95%CI)	P value	OR (95%CI)	P value
Pre-transplant serum creatinine	≥ 1.5 mg/dL	3.810 (1.203-12.063)	0.023		NS
	< 1.5 mg/dL
GR/WR (%)	< 1.0	2.667 (1.116-6.372)	0.027		NS
	≥ 1.0
GV/SLV (%)	< 60	2.806 (1.158-6.798)	0.022		NS
	≥ 60
Pre-transplant BMI	≥ 25 kg/m2	4.105 (1.435-11.752)	0.008	6.358 (2.026-19.958)	0.002
	< 25 kg/m2
ERD	With	5.143 (1.789-16.383)	0.003	9.593 (2.803-32.827)	< 0.001
	Without

PTHL: Post-transplant hyperlipidemia; GR/WR: Graft-to-recipient weight ratio; GV/SLV: Graft volume/standard liver volume; BMI: Body mass index; ERD: Early renal deficiency; NS: Not significant.