The Metabolic Syndrome in Transplantation: Risk of CV Events and Implications for Immunosuppression

Faculty

Needs Statement

Cardiovascular (CV) disease remains the leading cause of mortality in the United States.  Compared with age-matched persons in the general population, kidney transplant recipients are at a greater than 10-fold increased risk of CV mortality. Indeed, CV disease is responsible for approximately 50% of death with function after the first post-transplant year.  Maintenance of CV health has emerged as a top priority in the long-term management of renal transplant recipients.

The metabolic syndrome is a set of physiologic conditions that results in significantly increased risk for diabetes, CV disease, and mortality.  24% percent of American adults are diagnosed with the metabolic syndrome, the components of which are abdominal obesity, hypertriglyceridemia, low levels of high-density lipoprotein cholesterol, elevated blood pressure, and high levels of fasting blood glucose.  The metabolic syndrome occurs frequently among kidney transplant recipients; in a cohort of 606 European patients, 63% developed the metabolic syndrome within 6 years following transplantation.  

Conventional immunosuppressive agents exacerbate multiple components of the metabolic syndrome, including hypertension, dyslipidemia, hyperglycemia, and obesity.  As a result, effective management of CV risk following transplantation requires a comprehensive plan to control each component of the metabolic syndrome and any exacerbating risk factors, including maintenance immunosuppression regimen.

Transplant professionals are well aware of the CV risks accompanying transplantation. However, managing the risk in the context of the metabolic syndrome may provide an added opportunity to optimize post-transplant care. Therefore, the primary purpose of this symposium is to raise awareness of the incidence of and risk factors for the metabolic syndrome and its components. Faculty will also discuss the risk factors for each component of the metabolic syndrome, including the contribution of immunosuppressive agents. A final goal of the symposium will be to present the potential role of emerging immunosuppressive agents in mitigating the risks posed by the metabolic syndrome.

Target Audience

This activity is intended for surgeons, physicians, and pharmacists involved in the care of solid organ transplant recipients.

 

Objectives

1. Discuss the prevalence of the metabolic syndrome and its consequences in transplant recipients;
2. Describe the contribution of conventional immunosuppressive agents to the risk of developing the metabolic syndrome following transplantation;
3. Estimate the potential of emerging immunosuppressive regimens to influence post-transplant conditions related to the metabolic syndrome.

Accreditation

CME
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of Kentucky College of Medicine and CTI Clinical Trial & Consulting Services. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this educational activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

CPE
The University of Kentucky College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This knowledge-based activity has been assigned ACPE # 022-999-09-037-H04 and will award 1.00 contact hour(s) (0.1 CEU(s)) of continuing pharmacy education credit in states that recognize ACPE providers.

Statements of credit will indicate hours and CEUs based on participation and will be issued online at the conclusion of the activity. Successful completion includes completing the activity, its accompanying evaluation and/or posttest (score 70% or higher) and requesting credit online at the conclusion of the activity. The College complies with the Accreditation Standards for Continuing Pharmacy Education.

Faculty Disclosure

Dr. Young has no relevant relationships to disclose.
Dr. Kasiske provides contract research support for Merck, Schering-Plough, and Bristol-Myers Squibb.  He has received consultation fees from Litholink Inc., Wyeth, and Novartis.
Dr. Djamali has no relevant relationships to disclose.

Activity Sponsorship

This activity is jointly sponsored by the University of Kentucky and CTI Clinical Trial & Consulting Services. Supported by an unrestricted educational grant from Bristol-Myers Squibb.