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Bone loss after orthotopic liver transplantation
E Meys1, E Fontanges, N Fourcade
1INSERM Research Unit 234, Hôpital Edouard Herriot, Lyons, France.
The American Journal of Medicine
|November 1, 1994
Summary
Liver transplantation leads to significant bone loss and a high prevalence of vertebral fractures, even 1 year post-transplant. Early bone densitometry is crucial for identifying at-risk patients before surgery.
Area of Science:
- Hepatology
- Orthopedics
- Endocrinology
Background:
- Chronic liver disease impacts bone health.
- Liver transplantation is a treatment for end-stage liver disease.
- Bone loss and fractures are potential complications after transplantation.
Purpose of the Study:
- Assess changes in body composition and bone loss after liver transplantation.
- Determine if bone loss is linked to liver disease, sex, menopause, or graft rejection.
- Evaluate the prevalence of vertebral fractures in transplant recipients.
Main Methods:
- Cross-sectional and longitudinal studies compared bone mass and body composition.
- Dual energy X-ray absorptiometry (DXA) measured bone mineral content (BMC) and bone mineral density (BMD).
- Radiographs assessed vertebral fractures in patients before and after liver transplantation.
Main Results:
- Patients showed reduced lumbar spine BMD compared to normal values.
- Liver transplantation led to increased body fat and significant bone loss (3.5% decrease in spinal BMD).
- A high prevalence of vertebral fractures (29%) was observed post-transplantation.
Conclusions:
- Orthotopic liver transplantation is associated with a high prevalence of vertebral fractures.
- Longitudinal data reveal marked and rapid bone loss post-transplantation.
- Pre-transplant bone densitometry is recommended to identify patients at risk for osteoporosis.