Copyright ©The Author(s) 2020.
World J Gastroenterol. Jul 28, 2020; 26(28): 4018-4035
Published online Jul 28, 2020. doi: 10.3748/wjg.v26.i28.4018
Table 1 Metabolic syndrome criteria
Metabolic syndrome criteria
Waist circumference≥ 88 cm in females
≥ 102 cm in males
Triglycerides≥ 150 mg/dL
On drug treatment for elevated triglycerides
HDL≤ 40 mg/dL for men
≤ 50 mg/dL for women
On drug treatment for low HDL
HypertensionSystolic blood pressure ≥ 130 mmHg
Diastolic blood pressure ≥ 85 mmHg
On anti-hypertensive drug treatment for history of hypertension
DiabetesElevated fasting glucose ≥ 100 mg/dL
On drug treatment for elevated glucose
Table 2 Recommendations for pre-transplant evaluation in patients with non-alcoholic steatohepatitis cirrhosis
Evaluation and therapy for liver transplant candidates with non-alcoholic steatohepatitis
HypertensionTarget blood pressure 130/80
Initiate anti-hypertensive medical therapy
DiabetesBlood glucose control
Monitor insulin resistance
Hemoglobin A1c optimization
HyperlipidemiaInitiate statin therapy as appropriate
Renal dysfunctionRenal ultrasound
Measure GFR by quantitative method
Consider simultaneous liver/kidney transplantation
Cardiovascular diseaseIdentify cardiovascular risk factors—hypertension, diabetes, hyperlipidemia
Comprehensive cardiac evaluation to include EKG, DSE
Strong consideration for coronary angiography, in addition to OR in place of DSE
Carotid artery duplex
ObesityConsultation with nutritionist or dietician and exercise therapist
Consider consultation with bariatric surgeon
Consider pre-transplant or simultaneous LT + bariatric surgery if fail weight loss strategies with concurrent comorbid conditions