LAUSR

Cardiovascular disease (CVD) has been recognized as a major cause of both short- and longterm morbidity and mortality in liver transplant (LT) recipients for nearly 2 decades (1). Despite a growing body of literature and LT center experience demonstrating this burden, mortality related to CVD following LT has increased by 50% over this period. In fact, CVD is currently the most common cause of death in the first year following LT and the third most common cause of late posttransplant mortality(2). This increase in CVD-related events after LT coincides with a shift in the demographics of patients undergoing transplant. Nonalcoholic steatohepatitis, a hepatic manifestation of metabolic syndrome (including the well-recognized CVD risk factors obesity, hyperlipidemia, and type 2 diabetes mellitus), is now the second leading etiology of liver disease in LT recipients with end-stage liver disease (ESLD) (3). Furthermore, the age of LT recipients has steadily increased, with 20% being 65 years or older in the United States in 2017(4).