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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Serum testosterone levels after cardiac transplantation
Jessica Fleischer1, Donald J McMahon, Wylie Hembree
1Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Transplantation
|March 25, 2008
Summary
Low testosterone levels still occur in male heart transplant recipients, primarily due to prednisone-induced HPG suppression, not CsA. These levels are not linked to bone loss but may indicate long-term hypogonadism requiring evaluation.
Area of Science:
- Endocrinology
- Transplantation Medicine
- Bone Metabolism
Background:
- Early heart transplant recipients experienced testosterone decline and bone loss.
- Current understanding of post-transplant testosterone levels, CsA effects, and bone loss is limited.
Purpose of the Study:
- To investigate if low testosterone persists in heart transplant recipients with current immunosuppression protocols.
- To determine the causes of low testosterone (HPG suppression vs. direct testicular effects).
- To assess the relationship between testosterone levels and bone loss in patients receiving osteoporosis treatment.
Main Methods:
- Measured serum testosterone, estradiol, SHBG, and gonadotropins in 108 heart transplant recipients over 2 years.
- Recorded prednisone and CsA doses and levels.
- Assessed bone density and compared with hormonal levels.
Main Results:
- Testosterone levels were lowest in the first month post-transplant, normalizing by 2 months.
- Majority showed low gonadotropins, indicating HPG suppression.
- Persistent low testosterone occurred in 14-18% at 1-2 years, predicted by prednisone dose.
- No adverse CsA effects or link between testosterone and bone density change were found.
Conclusions:
- Low testosterone remains common in early post-transplant period, linked to prednisone-induced HPG suppression.
- Low testosterone is not associated with bone loss in patients receiving osteoporosis therapy.
- Long-term recipients may develop hypogonadism, necessitating evaluation.
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