Serum adipokine and inflammatory markers before and after liver transplantation in recipients with major cardiovascular events

In the nontransplant setting, aberrant serum adipokine levels are associated with cardiovascular (CV) disease. The effects of liver transplantation (LT) on serum adipokine levels and their association with post-LT CV disease have not been studied. A nested case-control study of 77 patients with major CV events more than 4 months after LT analyzed serum adiponectin, resistin, leptin, C-reactive protein, and apolipoprotein levels measured before transplantation and 4, 12, and 24 months after LT. Adiponectin and resistin levels decreased dramatically after LT in all patients. Recipients with CV disease had lower levels of adiponectin and higher levels of resistin, leptin, C-reactive protein, and apolipoprotein B100 than controls. The pre-LT adiponectin level was associated with a 16% increased risk for CV events for every 1 μg/mL decrease in adiponectin [hazard ratio (HR)=0.84, P=0.046]. Pre-LT C-reactive protein levels (HR=1.03, P=0.047) and 12-month C-reactive protein levels (HR=1.03, P=0.03) were associated with CV events after LT. Pre-LT Diabetes (HR=2.14, P=0.09), and post-LT resistin (HR=1.07, P=0.07), and apolipoprotein B (HR=1.08, P=0.08) were associated with a nonsignificantly increased risk of CV events in this small sample size. In conclusion, pre- and post-LT changes in serum adipokine and inflammatory markers may be signals of an increased risk of CV events after LT, but further study is needed. Liver Transpl 20:791-797, 2014.