LIPID ABNORMALITIES IN STABLE LIVER-TRANSPLANT RECIPIENTS - EFFECTS OF CYCLOSPORINE, TACROLIMUS, AND STEROIDS

Dyslipidemia is common after liver transplantation, but the underlying mechanisms are largely unknown. We studied the lipid profile of 27 li ver transplant recipients randomized to receive either cyclosporin (Cp A, n = 14) or tacrolimus (n = 13) and compared them with 20 healthy, m atched controls. Before transplantation, patients presented low total and low-density lipoprotein (LDL) cholesterol (as compared to controls ) that increased shortly, i.e., 3 months, after transplantation. Eight een months post-transplantation, total and LDL cholesterol levels decr eased to pretransplant values but tended to remain higher in CyA-treat ed patients. However, at that time, prednisone treatment was more prev alent among CyA-treated than tacrolimus-treated patients and fully acc ounted for the difference in cholesterol levels. Indeed, regardless of therapy, patients not receiving prednisone exhibited lower cholestero l levels than prednisone-treated patients and controls. We conclude th at prednisone therapy, rather than CyA or tacrolimus immunosuppression , seems to be the major determinant of increased cholesterol levels.