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Bone mineral density in pediatric transplant recipients
Mark W Daniels1, Darrell M Wilson, Helen G Paguntalan
1Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Transplantation
|September 16, 2003
Summary
Pediatric transplant recipients, especially cardiac and bone marrow, show significantly reduced bone density. This bone health deficit, including vertebral fractures, persists even after accounting for bone size, highlighting a critical post-transplant complication.
Area of Science:
- Pediatric Endocrinology
- Transplantation Medicine
- Skeletal Biology
Background:
- Reduced bone mass and fragility fractures are known complications after adult transplantation.
- Skeletal effects of transplantation in children and adolescents are less understood.
Purpose of the Study:
- To examine the skeletal status of pediatric patients post-cardiac, renal, or bone marrow transplantation.
- To compare bone mineral density (BMD) and bone mineral apparent density (BMAD) with age, sex, and ethnic-specific reference data.
Main Methods:
- Cross-sectional study of 36 children (ages 9-18) at least 1 year post-transplant.
- Dual-energy x-ray absorptiometry (DXA) measured bone mass at total hip, femoral neck, spine, and whole body.
- Calculation of Z-scores for areal BMD and volumetric BMAD.
Main Results:
- Cardiac transplant patients showed significantly lower BMD Z-scores at all sites.
- Bone marrow transplant (BMT) recipients had reduced BMD Z-scores at total hip, spine, and whole body.
- Reduced spine BMAD Z-scores persisted in cardiac and BMT groups; 3 patients had spinal fractures.
Conclusions:
- Pediatric cardiac and BMT recipients exhibit reduced BMD at multiple skeletal sites.
- Renal transplant recipients showed reduced whole body BMD.
- Reduced bone health, including vertebral fractures, is associated with pediatric cardiac, renal, and BMT.