CMV reactivation is associated with lower hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT)

Background and aims: Cardiovascular (CV) disease is an important cause of morbidity and mortality after liver transplantation (LT).In the general population endothelial biomarkers have been associated to cardiovascular (CV) risk.Little is known about the relationship between endothelial biomarkers in LT candidates.To analyse pre-LT serum biomarkers (day 0) and to evaluate if they have an association with CV risk after LT alone or in combination with classical CV risk factors.Method: Frozen plasma of 125 LT with a low FRS between 2014-2017 were analyze.At one year, patients with a high Frammingham Risk Score (FRS) or with metabolic syndrome (MS) were considered of high risk, as a surrogate marker for CV events.Endothelial biomarkers measured were: lpPLA2 measured by ELISA and adiponectine, VCAM1, IL6, TNF alfa and proBNP by Luminex.A multivariate analysis with clinical and endothelial biomarkers was done.Results: Mean age was 56 years, 78% were men, HCV cirrhosis was the most frequent ethiology (36%) followed by alcohol (25%).Before LT, 20% had arterial hypertension and 19% diabetes.At one yr post-LT, 33% were considered to have a high CV risk by FRS or MS.Logistic regression showed that age before LT (OR = 1.06; p = 0, 025), DM before LT (OR = 5, 77; p < 0, 001) were associated with high CV risk.Plasma levels of LpPLA2, adiponectine, TNF alfa and ProBNP were associated with Liver function (MELD and Child) ( p < 0, 05).LpPLA 2 showed a tendency through a high CV risk (OR = 2.82, p = 0, 089).A model with clinical and endothelial biomarkers was created.DM (OR 9, 6 3-31 p < 0, 001), obesity (OR 5, 1 IC 1.62-16 p = 0.005), tobacco use (OR 4.44 IC 1.26-15 p = 0, 02) and lpPLA2 (OR 8, 18 IC 1.5-44 p = 0, 015) were statistically significant associated with CV risk post-LT.Conclusion: Clinical variables such as age, obesity, DM before LT and tobacco use in combination with endothelial biomarkers (LpPLA2) could be useful to predict CV risk after LT.