Liver transplantation, an accepted treatment for some individuals with end stage liver disease, has long-term survival rates at 1, 3, and 5 years reported as 85.7, 77.6, and 72.1%, respectively (retrieved January 20, 2005 at www.optn.org/latestData/rptStrat.asp ). Ten year survival rates of 60% have also been documented in some studies of long-term survivors (Gonwa, 2001; Kizilisik et al., 2003; Planas et al., 2004). Liver transplant recipients share the same cardiovascular risk factors as the general population (Fernandez-Miranda et al., 2002; Johnston et al., 2002; Reuben, 2001), as well as other risk factors for atherosclerotic cardiovascular disease associated with immunosuppressant therapy (Neal et al., 2001; Rabkin et al., 2002; Varo et al., 2002). As a result of the additive nature of these risk factors, the incidence of cardiovascular disease is much higher in transplant recipients than in the general population. For example, the annual cardiovascular mortality rate is increased from 0.28% in the general population to 0.54% in renal transplant recipients where it accounts for 55% of the overall mortality. Up to 10% of the late mortality in liver transplant recipients has been attributed to cardiovascular disease (Rabkin et al., 2001); thus, it is one of the most frequent non-immune causes of death in this population (Asfar et al., 1996). Some cardiovascular risk factors, such as obesity, hypertension, dyslipidemia, and diabetes mellitus, occur frequently after liver transplantation (Munoz, 1995; Varo et al., 2002). In addition to risks conferred as a result of family history or other non-modifiable factors, the risk of acquiring atherosclerotic cardiovascular disease is increased (Reuben, 2001). Dietary changes, weight reduction, and exercise are mainstays of risk reduction therapy (Reuben, 2001); however, few studies have been conducted of lifestyle characteristics and their relationship to cardiovascular risk factors in liver transplant recipients. Thus, the primary aims of this pilot study are to:

1. Describe lifestyle characteristics (physical activity, dietary habits, smoking) and cardiovascular risk factors (dyslipidemia, hypertension, overweight/obesity, body fat distribution, metabolic syndrome, impaired glucose tolerance, plasma homocysteine concentrations, C-reactive protein) in long-term ( > 3 years post-transplant) liver transplant recipients.
2. Determine whether or not relationships exist between lifestyle characteristics and cardiovascular risk factors and delineate differences based on individual characteristics such as gender, race, education, type of transplant, immunosuppressive therapy regimen, physical activity level, smoking, and presence of metabolic syndrome.

The secondary aim is to:

Evaluate instruments and measures selected to evaluate lifestyle characteristics and cardiovascular risk factors from a biobehavioral perspective in this patient population.

Findings from a preliminary analysis are under reveiw for presentation at the American Tranplant Congress in May 2009.