Hyperlipidemia and cardiovascular disease after organ transplantation.

Hyperlipidemia, a frequent and persistent complication after solid organ transplantation, contributes to cardiovascular morbidity and mortality and may influence the development of allograft vasculopathy. The pathogenesis of posttransplantation hyperlipidemia is not fully understood, although several epidemiological factors are strongly implicated including age, weight, pretransplantation lipid levels, and immunosuppressive therapy. Management strategies to reduce hyperlipidemia and modify cardiovascular risk include dietary restrictions and the use of lipid-lowering agents. The selective use of immunosuppressants, such as tacrolimus, that have neutral or fewer adverse effects on lipid metabolism may also provide a useful option. A combination of lipid-lowering therapies and optimization of immunosuppressive regimens compatible with prolonged allograft survival is probably necessary to significantly reduce posttransplantation hyperlipidemia and its potentially harmful consequences.