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• W2160994085 abstract "Background Osteoporosis and related fractures are a major complication after organ transplantation. The aim of this study was to find out the frequency and predictors of osteoporotic fractures after cardiac or liver transplantation. Methods 235 consecutive patients who had a cardiac transplant (n=105; 88 men, 17 women) or a liver transplant (130; 75 men, 55 women) were followed. Vertebral fractures were assessed by a standardised analysis of spinal radiographs before and annually after transplantation. Clinical and non-vertebral fracture data were noted from hospital records. Findings In the first and second years after transplantation, the proportion of patients (Kaplan-Meier estimates) who had at least one vertebral fracture was slightly higher in the cardiac group (first year 21%, second year 27%) than in the liver group (first year 14%, second year 21%). In the third and fourth years, one third of patients from both groups had had one or more vertebral fractures. Non-vertebral fractures occurred in nine patients (7%) after liver transplantation and avascular necrosis of the hip head in three patients (3%) after cardiac transplantation. In both groups, no dose dependent effect of immunosuppressive therapy on fracture development could be identified. Independent predictors assessed by multivariate analysis were age (hazard ratio [95% CI] increase of 5 years, 1·71 [1·1–2·7]) and lumbar bone-mineral density (decrease of 1 SD t score, 1·97 [1·2–3·2]) in cardiac transplantation patients, and vertebral fractures before transplantation (6·07 [1·7–21·7]) in the liver group. Interpretation The high frequency of osteoporotic fractures in the 2 years after transplantation and the limitations of reliable fracture-risk predictions, show the need to investigate preventive therapies. Osteoporosis and related fractures are a major complication after organ transplantation. The aim of this study was to find out the frequency and predictors of osteoporotic fractures after cardiac or liver transplantation. 235 consecutive patients who had a cardiac transplant (n=105; 88 men, 17 women) or a liver transplant (130; 75 men, 55 women) were followed. Vertebral fractures were assessed by a standardised analysis of spinal radiographs before and annually after transplantation. Clinical and non-vertebral fracture data were noted from hospital records. In the first and second years after transplantation, the proportion of patients (Kaplan-Meier estimates) who had at least one vertebral fracture was slightly higher in the cardiac group (first year 21%, second year 27%) than in the liver group (first year 14%, second year 21%). In the third and fourth years, one third of patients from both groups had had one or more vertebral fractures. Non-vertebral fractures occurred in nine patients (7%) after liver transplantation and avascular necrosis of the hip head in three patients (3%) after cardiac transplantation. In both groups, no dose dependent effect of immunosuppressive therapy on fracture development could be identified. Independent predictors assessed by multivariate analysis were age (hazard ratio [95% CI] increase of 5 years, 1·71 [1·1–2·7]) and lumbar bone-mineral density (decrease of 1 SD t score, 1·97 [1·2–3·2]) in cardiac transplantation patients, and vertebral fractures before transplantation (6·07 [1·7–21·7]) in the liver group. The high frequency of osteoporotic fractures in the 2 years after transplantation and the limitations of reliable fracture-risk predictions, show the need to investigate preventive therapies. Osteoporosis in patients with organ transplants: a neglected problemOsteoporosis has been consistently reported in patients who have undergone solid-organ transplantation, such as kidney, heart, and liver. These patients have a striking increase in risk of vertebral and non-vertebral fractures.1 During the year after cardiac or liver transplantation, 20–50% of patients have fractures, and longitudinal studies indicate that most of these fractures occur after the operation.2,3, Most are vertebral fractures, which occur more commonly in women than in men. The rate of bone loss accelerates in the first year after cardiac and liver transplantations, then stabilises or declines at the lumbar spine, but at skeletal sites made of cortical bone such as the hip the acceleration continues for the next few years. Full-Text PDF" @default.
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• W2160994085 title "Frequency and predictors of osteoporotic fractures after cardiac or liver transplantation: a follow-up study" @default.
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• W2160994085 doi "https://doi.org/10.1016/s0140-6736(00)03641-2" @default.
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