Endocrine Abstracts

Introduction

Lung transplantation was associated with a 32% prevalence of hypercholesterolemia and a 41% prevalence of hypertriglyceridemia. The prevalence of dyslipidemia in liver transplant recipients is 43% and 31% –51%. In this report, we present 2 cases who developed dyslipidemia after transplantation.

Case 1

The blood test of a 73-year-old male patient who had lung transplantation about 3 years ago revealed Triglyceride (TG) 475 mg/dl (<150), LDL-Cholesterol: 382 mg/dl (<100), HDL 53 mg/dl (>40), Total cholesterol 431 mg/dl (<200) and HbA1C: 8.3. Six months ago, he was diagnosed with diabetes mellitus by his primary physician. He was on everolimus, prednisolone, and mycophenalate sodium therapy, and was referred to us. There were no cutaneous findings related to hyperlipidemia. After the diet and blood sugar regulation, the tests were repeated; TG was 422 mg/dl and LDL was 366 mg/dl. He had elevated liver function test (LFT) levels, and hepatitis panel and liver auto antibodies were negative. Atorvastatin 1× 10 mg was initiated on 14/02/2020. TG was 210 mg/dl (<150), and LDL cholesterol level was 123 mg/dl (<100).

Case 2

A 65-year-old female patient underwent liver transplantation from a cadaver on 12/09/2019 due to toxic hepatitis and on 25/09/2019 due to hepatic vein thrombosis after transplantation. Receiving tacrolimus and mycophenolic acid treatments after transplantation, she developed refractory dyslipidemia after the second transplant. Tests performed in February 2020 showed levels of Triglyceride 474 mg/dl (<150), LDL-Cholesterol 512 mg/dl (<100), Total Cholesterol 815mg/dl (<200) and HDL cholesterol 11 mg/dl (>50). Pravastatin 1 × 40 mg was initiated in February 2020 and intermittent lipid apheresis was performed. In April 2020, ezetimibe 1 × 10 mg was added to her treatment. In May 2020, LDL level was determined 186 mg/dl.

Discussion

Maintaining or improving allograft function after transplantation and reducing cardiovascular risk are main objectives during follow-up. Interventions for dyslipidemia have the effect of reducing cardiac events in clinical studies specific to transplant population.