{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:53:57Z","timestamp":1787241237656,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Although liver transplantation (LT) recipients are at high cardiovascular risk (CVR), the management of CVR factors (CVRF) after LT is far from optimal and needs to be improved. For this reason, we developed a multidisciplinary protocol to standardize the identification, risk stratification, management, and targets of therapy of CVRF during the first post\u2010LT year. The grade of identification and control of CVRF 12\u00a0months after LT in the postintervention cohort (LT January 2018\u2013January 2020, n\u00a0=\u00a0150) were compared with a control cohort who underwent LT between July 2015 and December 2016 (n\u00a0=\u00a0100). Before LT, the prevalence of metabolic\u2010associated fatty liver disease as the indication of LT and the presence of obesity were significantly higher in the postintervention cohort, whereas the prevalence of other CVRF and renal dysfunction tended to be higher. Cyclosporine A was used less frequently in the postintervention cohort, whereas everolimus tended to increase. At 12 months after LT, the proportion of patients with measured blood pressure (88% vs. 56%), glycosilated hemoglobin (HbA1c; 96% vs. 72%), and high\u2010density lipoprotein\/low\u2010density lipoprotein cholesterol (67% vs. 33%) was higher in the postintervention than in the control cohort (all\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). Blood pressure (64% vs. 36%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.02) and HbA1c (85% vs. 70%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.1) were within target in more individuals with hypertension and diabetes mellitus, respectively, in the postintervention cohort. Median total cholesterol levels were lower in the postintervention (184 mg\/dl; interquartile range [IQR], 160\u2013210 mg\/dl) than in the control cohort (212 mg\/dl; IQR, 186\u2013240 mg\/dl;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.02). At 2 years after LT, the incidence of cardiovascular events was 14% in the control cohort and 6% in the postintervention cohort (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u00a00.063). In conclusion, a multidisciplinary, multiprofessional strategy can achieve a higher grade of assessment and management of post\u2010LT CVR despite a worsening metabolic profile of LT recipients.\n                  <\/jats:p>","DOI":"10.1002\/lt.26443","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T03:35:21Z","timestamp":1646019321000},"page":"1332-1344","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":24,"title":["Results of a multidisciplinary strategy to improve the management of cardiovascular risk factors after liver transplantation"],"prefix":"10.1097","volume":"28","author":[{"given":"Lydia","family":"Sastre","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"},{"name":"Department of Gastroenterology and Hepatology,Hospital Son Espases,Palma de Mallorca,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Vi\u00f1als","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio J.","family":"Amor","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Yago","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Herv\u00e1s","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Trabal","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Molero","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Escud\u00e9","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Pagano","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Blasco","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplant Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Gilabert","sequence":"additional","affiliation":[{"name":"Radiology Department,Hospital Clinic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS),Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Colmenero","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS),Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd),Madrid,Spain"},{"name":"University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Navasa","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS),Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd),Madrid,Spain"},{"name":"University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Ortega","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department,Hospital Clinic,Barcelona,Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS),Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBERobn),Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1178-4897","authenticated-orcid":false,"given":"Gonzalo","family":"Crespo","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplant Unit,Hospital Clinic,Barcelona,Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS),Barcelona,Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red\u2010Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd),Madrid,Spain"},{"name":"University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"lt26443-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.jhep.2018.12.009","article-title":"Age and liver transplantation","volume":"70","year":"2019","journal-title":"J Hepatol"},{"key":"lt26443-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jhep.2018.02.012","article-title":"The efficacy of direct anti\u2010HCV drugs improves early post\u2010liver transplant survival and induces significant changes in waiting list composition","volume":"69","year":"2018","journal-title":"J Hepatol"},{"key":"lt26443-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.cgh.2020.05.064","article-title":"Nonalcoholic steatohepatitis is the most rapidly increasing indication for liver transplantation in the United States","volume":"19","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"lt26443-bib-0004-20250824","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1001\/jamainternmed.2014.2903","article-title":"The portrait of an adult liver transplant recipient in the United States from 1987 to 2013","volume":"174","year":"2014","journal-title":"JAMA Intern Med"},{"key":"lt26443-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1002\/lt.23950","article-title":"High early cardiovascular mortality after liver transplantation","volume":"20","year":"2014","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/TP.0000000000002852","article-title":"Incidence, predictors, and impact on survival of long\u2010term cardiovascular events after liver transplantation","volume":"104","year":"2020","journal-title":"Transplantation"},{"key":"lt26443-bib-0007-20250824","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/ajt.14401","article-title":"Sustained posttransplantation diabetes is associated with long\u2010term major cardiovascular events following liver transplantation","volume":"18","year":"2018","journal-title":"Am J Transplant"},{"key":"lt26443-bib-0008-20250824","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1097\/TP.0b013e31824cd5e6","article-title":"Control of blood pressure in liver transplant recipients","volume":"93","year":"2012","journal-title":"Transplantation"},{"key":"lt26443-bib-0009-20250824","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1097\/TP.0000000000001399","article-title":"Controlling diabetes after liver transplantation: room for improvement","volume":"100","year":"2016","journal-title":"Transplantation"},{"key":"lt26443-bib-0010-20250824","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1002\/lt.25613","article-title":"The impact of coronary artery disease and statins on survival after liver transplantation","volume":"25","year":"2019","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0011-20250824","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1002\/lt.25627","article-title":"Mind the gap: statin underutilization and impact on mortality in liver transplant recipients","volume":"25","year":"2019","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0012-20250824","article-title":"Poor practitioner adherence to clinical tobacco use guidelines in liver transplant recipients","volume":"8","year":"2022","journal-title":"Transplantation Direct"},{"key":"lt26443-bib-0013-20250824","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1111\/ajt.15706","article-title":"Blood pressure control according to clinical practice guidelines is associated with decreased mortality and cardiovascular events among liver transplant recipients","volume":"20","year":"2020","journal-title":"Am J Transplant"},{"key":"lt26443-bib-0014-20250824","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/lt.25973","article-title":"Liver transplant recipient, caregiver, and provider perceptions of cardiovascular disease and related risk factors after transplant","volume":"27","year":"2021","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0015-20250824","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1093\/eurheartj\/ehw272","article-title":"2016 ESC\/EAS guidelines for the management of dyslipidaemias","volume":"37","year":"2016","journal-title":"Eur Heart J"},{"key":"lt26443-bib-0016-20250824","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1093\/eurheartj\/ehw106","article-title":"2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)","volume":"37","year":"2016","journal-title":"Eur Heart J"},{"key":"lt26443-bib-0017-20250824","doi-asserted-by":"crossref","first-page":"140","DOI":"10.2337\/dc14-2441","article-title":"Management of hyperglycemia in type 2 diabetes, 2015: a patient\u2010centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes","volume":"38","year":"2015","journal-title":"Diabetes Care"},{"key":"lt26443-bib-0018-20250824","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","year":"2009","journal-title":"Circulation"},{"issue":"25 Suppl 2","key":"lt26443-bib-0019-20250824","first-page":"S49","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","year":"2014","journal-title":"Circulation"},{"key":"lt26443-bib-0020-20250824","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction\u2010associated fatty liver disease: an international expert consensus statement","volume":"73","year":"2020","journal-title":"J Hepatol"},{"key":"lt26443-bib-0021-20250824","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/gastro\/goaa068","article-title":"When evidence is lacking: a mixed\u2010methods approach for the development of practice guidance in liver transplantation","volume":"9","year":"2021","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"lt26443-bib-0023-20250824","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1002\/lt.25474","article-title":"The emerging role of nurse practitioners and physician assistants in liver transplantation","volume":"25","year":"2019","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0024-20250824","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1007\/s10620-019-05800-6","article-title":"Office\u2010based weight loss counseling is ineffective in liver transplant recipients","volume":"65","year":"2020","journal-title":"Dig Dis Sci"},{"key":"lt26443-bib-0025-20250824","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1097\/TP.0000000000001913","article-title":"Everolimus is associated with less weight gain than tacrolimus 2 years after liver transplantation: results of a randomized multicenter study","volume":"101","year":"2017","journal-title":"Transplantation"},{"key":"lt26443-bib-0026-20250824","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1002\/lt.26219","article-title":"Metabolic complications in liver transplantation recipients: how we can optimize long\u2010term survival","volume":"27","year":"2021","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0027-20250824","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/S2468-1253(19)30181-5","article-title":"Management of metabolic syndrome and cardiovascular risk after liver transplantation","volume":"4","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"lt26443-bib-0028-20250824","doi-asserted-by":"crossref","first-page":"432","DOI":"10.5500\/wjt.v11.i10.432","article-title":"Impact of immunosuppression on incidence of post\u2010transplant diabetes mellitus in solid organ transplant recipients: systematic review and meta\u2010analysis","volume":"11","year":"2021","journal-title":"World J Transplant"},{"key":"lt26443-bib-0029-20250824","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1002\/lt.26069","article-title":"Atherogenic dyslipidemia after liver transplantation: mechanisms and clinical implications","volume":"27","year":"2021","journal-title":"Liver Transpl"},{"key":"lt26443-bib-0030-20250824","article-title":"NAFLD and liver transplantation: disease burden, current management and future challenges","volume":"2","year":"2020","journal-title":"JHEP Rep"},{"key":"lt26443-bib-0031-20250824","first-page":"480","article-title":"Early detection, prevention and management of renal failure in liver transplantation","volume":"37","year":"2014","journal-title":"Gastroenterol Hepatol"},{"key":"lt26443-bib-0032-20250824","article-title":"Renal disease in the allograft recipient","volume":"46\u201347","year":"2020","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"lt26443-bib-0033-20250824","article-title":"Obesity is a risk factor for progression to kidney transplant waitlisting after liver transplantation","volume":"35","year":"2021","journal-title":"Clin Transplant"},{"key":"lt26443-bib-0034-20250824","article-title":"Inflammation and oxidative stress in diabetic kidney disease: the targets for SGLT2 inhibitors and GLP\u20101 receptor agonists","volume":"22","year":"2021","journal-title":"Int J Mol Sci"},{"key":"lt26443-bib-0035-20250824","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1002\/hep4.1876","article-title":"Personalizing diabetes management in liver transplant recipients: the new era for optimizing risk management","volume":"6","year":"2022","journal-title":"Hepatol Commun"},{"key":"lt26443-bib-0036-20250824","article-title":"Comanagement with nephrologist care is associated with fewer cardiovascular events among liver transplant recipients with chronic kidney disease","volume":"7","year":"2021","journal-title":"Transplant Direct"},{"key":"lt26443-bib-0037-20250824","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1002\/hep.30518","article-title":"Small dense low\u2010density lipoprotein cholesterol predicts cardiovascular events in liver transplant recipients","volume":"70","year":"2019","journal-title":"Hepatology"},{"key":"lt26443-bib-0038-20250824","article-title":"The role of arterial stiffness in the estimation of cardiovascular risk in liver transplant recipients","volume":"8","year":"2022","journal-title":"Transplant Direct"},{"key":"lt26443-bib-0039-20250824","doi-asserted-by":"crossref","first-page":"e434","DOI":"10.1016\/S2589-7500(21)00079-0","article-title":"Association between change in cardiovascular risk scores and future cardiovascular disease: analyses of data from the Whitehall II longitudinal, prospective cohort study","volume":"3","year":"2021","journal-title":"Lancet Digit Health"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lt.26443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lt.26443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:04:58Z","timestamp":1756080298000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/lt.26443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,25]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.26443","relation":{},"ISSN":["1527-6465","1527-6473"],"issn-type":[{"value":"1527-6465","type":"print"},{"value":"1527-6473","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,25]]},"assertion":[{"value":"2022-01-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}