The Relevant Mechanism Of Atherosclerosis After Liver Transplantation

Objecttive:To discuss the pathogenesis of atherosclerosis and cardiovascular disease through testing the levels of plasma macrophages scavenger receptor SRB I and CD36of the end-stage liver disease (ESLD) patients before and one year after liver transplantation; comparing traditional atherosclerosis risk factors such as blood lipid, blood pressure, blood glucose before and one year after liver transplantation; recording the incidence of cardiovascular disease in patients after liver transplantation during1year followed up. So as to pursue the possible way to prolong the long-term survival of patients after liver transplantation.Methods:Totally20patients received liver transplantation in the first center hospital of tianjin organ transplant center during Oct2011and Oct2013, who excluded coronary heart disease after the biochemical examination, the chest X-ray, electrocardiogram, echocardiography and coronary artery CT or CAG. All the patients’ clinical data was recorded, such as gender, age, smoking history, CAD family history, diabetes family history, triglyceride, total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol, uric acid, fasting plasma glucose, etc. Finally there were15patients whose clinical datas were integrated. Immunosuppressant scheme adopts mycophenolate mofetil (MMF)+FK506+hormone triple regimen after liver transplantation. Testing the changes of expression of plasma macrophages scavenger receptor SRB I and CD36before transplantation and1year after liver transplantation with Western-blot. Statistic method:analyze the data used the statistic software SPSS17.0. Chi square test were used to compare numeration data between two groups. Scale data were expressed with mean±SD, followed T test was used to compare scale data between groups. P<0.05was considered to be statistic significance.Results:1. Followed up for1year, the levels of TC, TG, LDL-C are higher, systolic blood pressure is higher, HDL-C is reduced.2.The multi-factor Logistic regression analysis results show that is easier to occur hyperlipidemia, hypertension and other cardiovascular risk factors after liver transplantation, P<0.05.3. Followed up for1year,1case was diagnosed with non ST segment elevation myocardial infarction (mi), who suffer coronary artery intervention treatment,1case was diagnosed with atrial fibrillation.4.The expression levels of SRB I was reduced while the levels of CD36was rasied one year after liver transplantation compared with preoperative, P<0.05. Conclusion:1. The level of TC, TG, LDL-C, systolic blood pressure are rising after liver transplantation, while the HDL-C level is reduced. It proved that dyslipidemia and hypertension are easier happened after liver transplantation and hypertension, dyslipidemia are the important risk factors for atherosclerosis after liver transplantation.2. The expression level of plasma macrophages scavenger receptor SRB I is reduced after liver transplantation compared with that before the transplantation, SRB I involved in the process of lipid metabolism, is the protective factor of atherosclerosis, has the role on resistance to atherosclerosis.3. The expression levelof plasma macrophages scavenger receptor CD36is rised after liver transplantation compared with that before the transplantation.CD36plays an important role in the formation of foam cells,it’s involved in the formation of atherosclerosis (AS).4. The incidence of new-onset diabetes is improved significantly, it’s mechanism may be related to the immunosuppressive therapies after liver transplantation.