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Review

The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review

by
Yeung Jek Ho
1,
Audrey Su-Min Koh
1,
Zhi Hao Ong
1,
Cheng Han Ng
1,*,
Gwyneth Kong
1,
Nicholas W.S. Chew
2,
Hui Ning Lim
1,
M. Shadab Siddiqui
3 and
Mark Dhinesh Muthiah
1,4,*
1
National University Centre for Organ Transplantation, National University Health System, Singapore 119074, Singapore
2
National University Heart Centre, Department of Cardiology, National University Hospital, Singapore 119074, Singapore
3
Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, VA 23284, USA
4
Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
*
Authors to whom correspondence should be addressed.
Transplantology 2021, 2(3), 264-273; https://doi.org/10.3390/transplantology2030025
Submission received: 31 May 2021 / Revised: 20 June 2021 / Accepted: 25 June 2021 / Published: 3 July 2021
(This article belongs to the Special Issue Liver Transplantation: Current Status and Future Challenges)
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Abstract

(1) Background: Treatment of dyslipidemia via statin therapy in the non-liver transplant (LT) population is associated with a mortality benefit; however, the impact of statin therapy in post-LT population is not well-defined. This meta-analysis seeks to investigate the safety and efficacy of statin therapy in post-LT patients. (2) Methods: A systematic literature search on Medline and EMBASE database was conducted. A single-arm proportional meta-analysis and conventional pair-wise meta-analysis were performed to compare different outcomes with a random effects model. (3) Results: A total of 11 studies were included in this study, with 697 LT recipients identified to be on statin therapy. Statins were underutilized with only 32% (95% CI: 0.15–0.52) of 1094 post-LT patients on therapy. The incidence of adverse events of 14% (95% CI: 0.05–0.25) related to statin therapy was low. A significant mortality benefit was noted in patients on statin therapy with HR = 0.282 (95% CI: 0.154–0.517, p < 0.001), and improved lipid profiles post LT. The use of statins also significantly decreased odds of graft rejection (OR = 0.33; 95% CI: 0.15–0.73) and hepatocellular carcinoma (HCC) recurrence (HR = 0.32, 95% CI: 0.11–0.89). (4) Conclusions: Statin therapy is safe and efficacious in post-LT patients. Future studies to evaluate the effects of interactions between statins and immunosuppressant therapy are warranted.
Keywords: hyperlipidemia; post-liver transplant; statin; graft rejection hyperlipidemia; post-liver transplant; statin; graft rejection

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MDPI and ACS Style

Ho, Y.J.; Koh, A.S.-M.; Ong, Z.H.; Ng, C.H.; Kong, G.; Chew, N.W.S.; Lim, H.N.; Siddiqui, M.S.; Muthiah, M.D. The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review. Transplantology 2021, 2, 264-273. https://doi.org/10.3390/transplantology2030025

AMA Style

Ho YJ, Koh AS-M, Ong ZH, Ng CH, Kong G, Chew NWS, Lim HN, Siddiqui MS, Muthiah MD. The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review. Transplantology. 2021; 2(3):264-273. https://doi.org/10.3390/transplantology2030025

Chicago/Turabian Style

Ho, Yeung Jek, Audrey Su-Min Koh, Zhi Hao Ong, Cheng Han Ng, Gwyneth Kong, Nicholas W.S. Chew, Hui Ning Lim, M. Shadab Siddiqui, and Mark Dhinesh Muthiah. 2021. "The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review" Transplantology 2, no. 3: 264-273. https://doi.org/10.3390/transplantology2030025

APA Style

Ho, Y. J., Koh, A. S.-M., Ong, Z. H., Ng, C. H., Kong, G., Chew, N. W. S., Lim, H. N., Siddiqui, M. S., & Muthiah, M. D. (2021). The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review. Transplantology, 2(3), 264-273. https://doi.org/10.3390/transplantology2030025

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