The purpose of this study was to examine the nutrition-related risk factors for premature coronary heart disease (CHD) is asymptomatic adult liver transplant recipients. The specific aims were to: (1) describe selected nutrition-related risk factors for CHD in adults with end-stage liver disease before liver transplantation and at six months after liver transplantation, (2) identify selected changes in nutrition-related risk factors for CHD in adults that occur from before liver transplantation to six months after liver transplantation, and (3) determine if selected nutrition-related CHD risk factor changes occur after liver transplantation that may place adult recipients at greater risk for premature CHD.

This study design was a descriptive pre-post design, using secondary analysis of data collected as part of the routine liver transplantation clinical evaluation protocol at a large university medical center in the southeastern United States. A convenience sample of 29 adult patients who were being evaluated for liver transplantation participated in this study. Nutrition-related risk factors for CHD were described in patients with end-stage liver disease prior to transplantation, and again at six months after liver transplantation. The data collected before transplantation were compared with the data collected after transplantation to identify changes. Comparisons of change with respect to the two immunosuppression regimens were made. Demographic data were analyzed with univariate descriptive statistics. Pre-post data on the obesity and lipid concentration variables were analyzed with paired t-tests. Change data were analyzed with 2-group t-tests.

This study had several important findings and implications for nursing. Risk factors for CHD not present before transplantation were present at six months after transplantation. Although there was not evidence that obesity or hyperlipidemia were independent risk factors for CHD in the study sample, when considered in combination, these factors became clinically important as part of a multiple cause/multiple effect profile. There was evidence that the drug cyclosporine was associated with significantly higher serum lipid concentrations than FK-506. These findings support the development of nursing interventions designed to reduce the development of lifestyle and disease-related risk factors for CHD in patients following liver transplantation.