Is everolimus linked to metabolic syndrome in liver transplant recipients?

  • Εvangelos CholongitasEmail author
  • Argyro Koukoufiki
  • Chrysoula Pipili
  • Nikolaos Antoniadis
  • Ioannis Fouzas
  • Anna-Bettina Haidich
  • Ioannis Goulis
Original Article



As the mortality rates after liver transplantation (LT) have been reduced, the attention has shifted to additional conditions which still compromise the quality of life and the survival of these patients, such as the post-LT metabolic syndrome (MS). In order to determine the prevalence and the factors associated with the post-LT MS, we carried out the present study.


One hundred and six LT recipients, after completing at least 1 year follow up after LT, were included in the study. Data on clinical, laboratory parameters and immunosuppressive therapy before and after LT were recorded. MS was defined as per current diagnostic criteria.


MS was prevalent in 47.2% (50 of 106 patients) and was not associated with the LT indications and the time period after LT. Univariate analysis showed that history of diabetes mellitus before (odds ratio [OR] 3.2, 95% confidence interval [CI] 1.046–9.918, p = 0.042) and after LT (OR 6.03, 95% CI 2.18–16.67, p = 0.001), the age at the time of baseline visit (OR 1.077, 95% CI 1.033–1.124, p = 0.001) and the everolimus-based immunosuppression (OR 1.23, 95% CI 1.003–1.33, p = 0.019) were significantly associated with MS. Notably, everolimus administration was the only factor independently associated with the presence of post-LT MS (OR 1.026, 95% CI 1.004–1.047, p = 0.019). More specifically, everolimus was linked to the presence of arterial hypertension (OR 1.02, 95% CI 1.0–1.03, p = 0.05) and hyperlipidemia (OR 2.87, 95% CI 1.28–6.56, p = 0.011).


Our study demonstrated for the first time that everolimus was independently associated with post-LT MS. Nevertheless, more robust studies are required to confirm these findings.


Complications Diabetes mellitus Everolimus Immunosuppression Liver transplantation Mammalian target of rapamycin inhibitor 


Compliance with ethical standards

Conflict of interest

EC,AK, CP, NA,IF, A-BH, and IG declare that they have no conflict of interest.

The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki and was not supported by external institution or agency. Informed consent was obtained from all individual participants included in the study.


The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.


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Copyright information

© Indian Society of Gastroenterology 2019

Authors and Affiliations

  • Εvangelos Cholongitas
    • 1
    • 2
    Email author
  • Argyro Koukoufiki
    • 1
  • Chrysoula Pipili
    • 3
  • Nikolaos Antoniadis
    • 4
  • Ioannis Fouzas
    • 4
  • Anna-Bettina Haidich
    • 5
  • Ioannis Goulis
    • 1
  1. 1.4th Department of Internal MedicineMedical School of Aristotle University, Hippokration General Hospital of ThessalonikiThessalonikiGreece
  2. 2.First Department of Internal Medicine, Laiko General HospitalMedical School of National and Kapodistrian University of Athens, Laiko General HospitalAthensGreece
  3. 3.Renal Clinical FellowQueen Elizabeth University HospitalGlasgowUK
  4. 4.Department of Transplant SurgeryAristotle University of ThessalonikiThessalonikiGreece
  5. 5.Department of Hygiene and EpidemiologyMedical School of Aristotle University of ThessalonikiThessalonikiGreece

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