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BOMSS guidance further specifies monitoring responsibilities: specialist multidisciplinary team (MDT) follow-up is recommended for at least two years after surgery, with lifelong monitoring thereafter, typically in primary care

These processes significantly elevate cardiovascular risks, including thrombosis and vascular inflammation

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F.AbdeenA.AbdelkaderA.YoussefM.et al (2022)

Contributing factors include: reduced nutritional intake (proteins, essential amino acids, competition between amino acid transporters, vitamin insufficiency [riboflavin: GSSG reductase, nicotinic acid: NADPH, pyridoxine (B 6 ): SAMe pathway], mitochondrial dysfunction: ATP deficiency, down regulation SAMe synthase, oxidation of SAMe pathway enzymes, enhanced GSH utilization: conjugation reactions (toxins, drugs), and overwhelming oxidative challenge

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