Kostbehandling av hyperlipidemi hos transplanterte

Hyperlipidemia often occurs after transplantation and may contribute to increased cardiovascular morbidity. The cause is multifactorial, including weight, age, pretransplant lipids, medication and renal function. Several approaches to the post-transplantation lipid lowering therapy have been advocated. The primary strategy is the dietary modification whith weight management. Low-dose HMG-CoA reductase inhibitors (statines) have been used successfully. Current nutrition recommendations are to limit dietary cholesterol intake to 300 mg/day, not more than 30 % of total calories from fat, and saturated fat intake limited to 10% of total calories. The effect of dietary intervention on post-transplant hyperlipidemia has been evaluated by several centers, and the results are not always consistent. Problems with the patients’ compliance with the prescribed diet, combined with the fact that severals of the studies are small, contributes to the difficulties in analysing the data received in the studies. It seems like weight reduction is of essential importance to successfully lowering the lipids in post-transplant patients with hyperlipidemia, and the immunosuppressive treatment is likely to be the main reason to developing post-transplant hyperlipidemia. In some studies the effectiveness in treating the patients with diets containing fish oil, soy protein or high amounts of monounsaturated fatty acids have been advocated, and the results are very optimistic. More studies have to be done, and greater efforts have to be put on the weight reduction part of the treatment of post-transplant patients with hyperlipidemia