Transplantation Osteoporosis

Overview

Journal Curr Osteoporos Rep

Publisher Current Science

Specialties Endocrinology
Orthopedics

Date 2007 Feb 27

PMID 17320025

Citations 2

Authors

Peter R Ebeling

Affiliations

Soon will be listed here.

Abstract

Transplantation is an established therapy for end-stage diseases of the kidney, endocrine pancreas, heart, liver, and lung, and for many hematologic disorders. Improved survival rates have been accompanied by increased recognition of previously neglected long-term complications of transplantation such as fractures and osteoporosis. Pretransplantation bone disease and immunosuppressive therapy result in rapid bone loss and increased fracture rates early after transplantation. Patients should be assessed and pretransplantation bone disease should be treated. Preventive therapy initiated in the immediate posttransplantation period is indicated in patients with osteopenia or osteoporosis, as further bone loss will occur in the first several months after transplantation. Long-term organ transplant recipients should also have bone mass measurement and treatment of osteoporosis. Bisphosphonates are the most promising approach for the management of transplantation osteoporosis. Active vitamin D metabolites may have additional benefits in reducing hyperparathyroidism, particularly after kidney transplantation. Large, multicenter treatment trials with oral or parenteral bisphosphonates and calcitriol are recommended.

Citing Articles

Prevalence of Musculoskeletal and Metabolic Disorders in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis.

Herreros-Carretero A, Berlanga-Macias C, Martinez-Vizcaino V, Torres-Costoso A, Pascual-Morena C, Hernandez-Castillejo L Transpl Int. 2024; 37():12312.

PMID: 38720821 PMC: 11076774. DOI: 10.3389/ti.2024.12312.

The transplant patient and transplant medicine in family practice.

Hughes L J Family Med Prim Care. 2015; 3(4):345-54.

PMID: 25657941 PMC: 4311340. DOI: 10.4103/2249-4863.148106.

References

Stehman-Breen C, Sherrard D, Alem A, Gillen D, Heckbert S, Wong C . Risk factors for hip fracture among patients with end-stage renal disease. Kidney Int. 2000; 58(5):2200-5. DOI: 10.1111/j.1523-1755.2000.00394.x. View

Tauchmanova L, Selleri C, De Rosa G, Pagano L, Orio F, Lombardi G . High prevalence of endocrine dysfunction in long-term survivors after allogeneic bone marrow transplantation for hematologic diseases. Cancer. 2002; 95(5):1076-84. DOI: 10.1002/cncr.10773. View

Grotz W, Nagel C, Poeschel D, Cybulla M, Uhl M, Strey C . Effect of ibandronate on bone loss and renal function after kidney transplantation. J Am Soc Nephrol. 2001; 12(7):1530-1537. DOI: 10.1681/ASN.V1271530. View

Stempfle H, Werner C, Echtler S, Assum T, Meiser B, Angermann C . Rapid trabecular bone loss after cardiac transplantation using FK506 (tacrolimus)-based immunosuppression. Transplant Proc. 1998; 30(4):1132-3. DOI: 10.1016/s0041-1345(98)00181-x. View

Lee W, Kang M, Baek K, Oh E, Oh K, Lee K . The skeletal site-differential changes in bone mineral density following bone marrow transplantation: 3-year prospective study. J Korean Med Sci. 2002; 17(6):749-54. PMC: 3054966. DOI: 10.3346/jkms.2002.17.6.749. View

Monegal A, Navasa M, Guanabens N, Peris P, Pons F, Martinez de Osaba M . Bone disease after liver transplantation: a long-term prospective study of bone mass changes, hormonal status and histomorphometric characteristics. Osteoporos Int. 2001; 12(6):484-92. DOI: 10.1007/s001980170094. View

Tschopp O, Boehler A, Speich R, Weder W, Seifert B, Russi E . Osteoporosis before lung transplantation: association with low body mass index, but not with underlying disease. Am J Transplant. 2002; 2(2):167-72. DOI: 10.1034/j.1600-6143.2002.020208.x. View

Alem A, Sherrard D, Gillen D, Weiss N, Beresford S, Heckbert S . Increased risk of hip fracture among patients with end-stage renal disease. Kidney Int. 2000; 58(1):396-9. DOI: 10.1046/j.1523-1755.2000.00178.x. View

Bianda T, Linka A, Junga G, Brunner H, Steinert H, Kiowski W . Prevention of osteoporosis in heart transplant recipients: a comparison of calcitriol with calcitonin and pamidronate. Calcif Tissue Int. 2000; 67(2):116-21. DOI: 10.1007/s00223001126. View

10.

Lee W, Cho S, Oh E, Oh K, Lee J, Yoon K . The effect of bone marrow transplantation on the osteoblastic differentiation of human bone marrow stromal cells. J Clin Endocrinol Metab. 2002; 87(1):329-35. DOI: 10.1210/jcem.87.1.8135. View

11.

Goffin E, Devogelaer J, Depresseux G, Squifflet J, Pirson Y . Osteoporosis after organ transplantation. Lancet. 2001; 357(9268):1623. DOI: 10.1016/s0140-6736(00)04766-8. View

12.

Park K, Hay J, Lee S, Lee Y, Wiesner R, Porayko M . Bone loss after orthotopic liver transplantation: FK 506 versus cyclosporine. Transplant Proc. 1996; 28(3):1738-40. View

13.

Stempfle H, Werner C, Echtler S, Wehr U, Rambeck W, Siebert U . Prevention of osteoporosis after cardiac transplantation: a prospective, longitudinal, randomized, double-blind trial with calcitriol. Transplantation. 1999; 68(4):523-30. DOI: 10.1097/00007890-199908270-00014. View

14.

Epstein S . Post-transplantation bone disease: the role of immunosuppressive agents and the skeleton. J Bone Miner Res. 1996; 11(1):1-7. DOI: 10.1002/jbmr.5650110102. View

15.

Hommann M, Abendroth K, Lehmann G, Patzer N, Kornberg A, Voigt R . Effect of transplantation on bone: osteoporosis after liver and multivisceral transplantation. Transplant Proc. 2002; 34(6):2296-8. DOI: 10.1016/s0041-1345(02)03242-6. View

16.

Schwarz C, Mitterbauer C, Heinze G, Woloszczuk W, Haas M, Oberbauer R . Nonsustained effect of short-term bisphosphonate therapy on bone turnover three years after renal transplantation. Kidney Int. 2003; 65(1):304-9. DOI: 10.1111/j.1523-1755.2004.00369.x. View

17.

Giannini S, DAngelo A, Carraro G, Nobile M, Rigotti P, Bonfante L . Alendronate prevents further bone loss in renal transplant recipients. J Bone Miner Res. 2001; 16(11):2111-7. DOI: 10.1359/jbmr.2001.16.11.2111. View

18.

Ninkovic M, Love S, Tom B, Alexander G, Compston J . High prevalence of osteoporosis in patients with chronic liver disease prior to liver transplantation. Calcif Tissue Int. 2002; 69(6):321-6. DOI: 10.1007/s00223-001-2028-4. View

19.

Millonig G, Graziadei I, Eichler D, Pfeiffer K, Finkenstedt G, Muehllechner P . Alendronate in combination with calcium and vitamin D prevents bone loss after orthotopic liver transplantation: a prospective single-center study. Liver Transpl. 2005; 11(8):960-6. DOI: 10.1002/lt.20466. View

20.

Kapetanakis E, Antonopoulos A, Antoniou T, Theodoraki K, Zarkalis D, Sfirakis P . Effect of long-term calcitonin administration on steroid-induced osteoporosis after cardiac transplantation. J Heart Lung Transplant. 2005; 24(5):526-32. DOI: 10.1016/j.healun.2004.02.016. View