The Risk of Cholelithiasis in Patients After Heart Transplantation

Overview

Journal Arch Med Sci

Specialty General Medicine

Date 2014 Apr 5

PMID 24701214

Citations 2

Authors

Piotr Wegrzyn

Marcin Popiolek

Piotr Przybylowski

Karol Wierzbicki

Kornelia Zareba

Irena Milaniak

Boguslaw Kapelak

Krzysztof Bartus

Roman Pfitzner

Jerzy Sadowski

Affiliations

Soon will be listed here.

Abstract

Introduction: Extended immunosuppressive treatment in patients after heart transplantation modifies etiopathogenesis and occurrence of many diseases in this population. The aim of the present study was to evaluate the frequency and to define risk factors for cholelithiasis after heart transplantation (HTX).

Material And Methods: The study population consisted of 176 subjects. Of them, 24 patients (group A) presented with symptomatic cholelithiasis. Another group of 24 patients without cholelithiasis (group B) served as controls. Both groups were similar with respect to age, gender and follow-up after the transplant. Clinical interview, surgical and hospitalization data were collected from medical records.

Results: The groups did not differ in demographic features. There were statistical differences (p < 0.05) between group A and B in rejection reaction, doses of immunosuppressive drugs, type 2 diabetes, serum lipid disorders and acute rejection episodes. These events were caused by modification of treatment, especially the immunosuppressive regimen. Group A consisted of 75% men and 25% women. The frequency of symptomatic cholelithiasis was 11.7% in men and 27.3% in women, on average 19.5%. Mean time to cholelithiasis following HTX was 37.9 ±4.9 (Me = 41.5) months, 27.7 ±8.2 (Me = 30.0) months in women and 41.3 ±5.9 (Me = 41.5) months in men. The female to male ratio was 2.3: 1.

Conclusions: Cholelithiasis following HTX was significantly more frequent as compared with the non-transplant population. Patients with cholelithiasis required more aggressive immunosuppression because of more frequent episodes of acute transplant rejection. Patients with cholelithiasis significantly more frequently showed increased glycemia and blood lipids, which could be the side effect of intensive immunosuppressive therapy.

Citing Articles

Coronary revascularization after heart transplant - the search for prognostic factors.

Guzik B, Szczepanek E, Niewiara L, Nosal M, Wierzbicki K, Krzanowski M Arch Med Sci. 2020; 16(4):789-795.

PMID: 32542079 PMC: 7286336. DOI: 10.5114/aoms.2017.71847.

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation.

Nowacki M, Nazarewski L, Kloskowski T, Tyloch D, Pokrywczynska M, Pietkun K Arch Med Sci. 2016; 12(5):1158-1173.

PMID: 27695507 PMC: 5016594. DOI: 10.5114/aoms.2016.61919.

References

Aliabadi A, Cochrane A, Zuckermann A . Current strategies and future trends in immunosuppression after heart transplantation. Curr Opin Organ Transplant. 2012; 17(5):540-5. DOI: 10.1097/MOT.0b013e328358000c. View

Lord R, Ho S, Coleman M, Spratt P . Cholecystectomy in cardiothoracic organ transplant recipients. Arch Surg. 1998; 133(1):73-9. DOI: 10.1001/archsurg.133.1.73. View

Richardson W, Surowiec W, Carter K, Howell T, Mehra M, Bowen J . Gallstone disease in heart transplant recipients. Ann Surg. 2003; 237(2):273-6. PMC: 1522133. DOI: 10.1097/01.SLA.0000048975.71993.D2. View

Barten M, Rahmel A, Garbade J, Bold A, Bittner H, Dhein S . Pharmacodynamic monitoring of the conversion of cyclosporine to tacrolimus in heart and lung transplant recipients. Transplant Proc. 2006; 37(10):4532-4. DOI: 10.1016/j.transproceed.2005.10.091. View

McMurray J, Adamopoulos S, Anker S, Auricchio A, Bohm M, Dickstein K . ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the.... Eur Heart J. 2012; 33(14):1787-847. DOI: 10.1093/eurheartj/ehs104. View

Feola M, Lombardo E, Testa M, Avogadri E, Piccolo S, Vado A . Prognostic factors of mid-term clinical outcome in congestive heart failure patients discharged after acute decompensation. Arch Med Sci. 2012; 8(3):462-70. PMC: 3400912. DOI: 10.5114/aoms.2012.29401. View

Barten M, Rahmel A, Boldt A, Dhein S, Bittner H, Tarnok A . Pharmacodynamic monitoring of the immunosuppressive therapy in patients after heart transplantation: whole blood flow cytometric analysis of lymphocyte function. Comput Biol Med. 2006; 37(10):1367-73. DOI: 10.1016/j.compbiomed.2006.11.001. View

White M, Haddad H, Leblanc M, Giannetti N, Pflugfelder P, Davies R . Conversion from cyclosporine microemulsion to tacrolimus-based immunoprophylaxis improves cholesterol profile in heart transplant recipients with treated but persistent dyslipidemia: the Canadian multicentre randomized trial of tacrolimus vs.... J Heart Lung Transplant. 2005; 24(7):798-809. DOI: 10.1016/j.healun.2004.05.023. View

Bhatia D, Bowen J, Money S, Van Meter Jr C, McFadden P, Kot J . The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation. Ann Surg. 1997; 225(6):686-93; discussion 693-4. PMC: 1190870. DOI: 10.1097/00000658-199706000-00006. View

10.

Baczkowska T, Durlik M . Calcineurin inhibitor sparing immunosuppressive regimens in kidney allograft recipients. Pol Arch Med Wewn. 2009; 119(5):318-25. View

11.

Sekhri V, Sanal S, Delorenzo L, Aronow W, Maguire G . Cardiac sarcoidosis: a comprehensive review. Arch Med Sci. 2012; 7(4):546-54. PMC: 3258766. DOI: 10.5114/aoms.2011.24118. View

12.

Englesbe M, Dubay D, Wu A, Pelletier S, Punch J, Franz M . Gallbladder disease in cardiac transplant patients: a survey study. Arch Surg. 2005; 140(4):399-403. DOI: 10.1001/archsurg.140.4.399. View

13.

Bateson M . Gallbladder disease and cholecystectomy rate are independently variable. Lancet. 1984; 2(8403):621-4. DOI: 10.1016/s0140-6736(84)90605-6. View

14.

Takeyama H, Sinanan M, Fishbein D, Aldea G, Verrier E, Salerno C . Expectant management is safe for cholelithiasis after heart transplant. J Heart Lung Transplant. 2006; 25(5):539-43. DOI: 10.1016/j.healun.2005.12.010. View

15.

Halloran P, Miller L . In vivo immunosuppressive mechanisms. J Heart Lung Transplant. 1996; 15(10):959-71. View

16.

Spes C, Angermann C, Beyer R, Schreiner J, Lehnert P, Kemkes B . Increased incidence of cholelithiasis in heart transplant recipients receiving cyclosporine therapy. J Heart Transplant. 1990; 9(4):404-7. View

17.

Pethig K, Heublein B, Wahlers T, Dannenberg O, Oppelt P, Haverich A . Mycophenolate mofetil for secondary prevention of cardiac allograft vasculopathy: influence on inflammation and progression of intimal hyperplasia. J Heart Lung Transplant. 2004; 23(1):61-6. DOI: 10.1016/s1053-2498(03)00097-4. View

18.

Garlicki M, Czub P, Labus K, Ehrlich M, Rdzanek H . Conversion from cyclosporine to tacrolimus improves renal function and lipid profile after cardiac transplantation. Ann Transplant. 2006; 11(1):24-7. View