Premium
Osteoporosis after liver transplantation
Author(s) -
Compston Juliet E.
Publication year - 2003
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2003.50044
Subject(s) - medicine , osteoporosis , liver transplantation , transplantation , bone mineral , bone disease , bone density , surgery , bone density conservation agents , secondary hyperparathyroidism , vitamin d and neurology , hyperparathyroidism , complication , incidence (geometry) , parathyroid hormone , calcium , physics , optics
Osteoporosis remains a serious potential complication of liver transplantation, although its incidence may be significantly reduced by the use of lower doses of glucocorticoids. Additional factors likely to contribute to its pathogenesis include other immunosuppressive agents, particularly cyclosporin A and FK506, vitamin D insufficiency, secondary hyperparathyroidism, hypogonadism and pre‐existing bone disease. Bone density assessment and spinal X‐rays should be performed before transplantation to assess subsequent fracture risk and vitamin D and gonadal status assessed. Measures should be taken to optimise bone health prior to transplantation; in those with low bone mineral density and/or previous fragility fracture, prophylaxis against bone loss after transplantation should be considered. Although anti‐fracture efficacy has not been established for any agent there is evidence, mainly in patients undergoing other forms of solid organ transplantation, that repeated infusions of pamidronate may be effective in preventing bone loss.