Symptomatic osteonecrosis of the hip after orthotopic liver transplantation

Patients who require long-term steroid use for immunosuppression after organ transplantation are at risk for the development of osteonecrosis. The purpose of this study was to determine the prevalence of symptomatic osteonecrosis of the hip in patients who were managed with corticosteroids for immunosuppression after orthotopic liver transplantation. We reviewed the relationship of the administration and dosage of steroids in 203 patients who underwent orthotopic liver transplantation. Overall, 29 of the 203 patients (14%) complained of hip pain, but only 3 patients (2%) developed symptomatic osteonecrosis of the hip. The osteonecrosis was diagnosed an average of 31 months after transplantation (range, 26-38 months). There was no association noted between steroid dose and the development of osteonecrosis. Routine screening for osteonecrosis of asymptomatic liver transplant patients is not necessary.