Course of vitamin D levels before and after liver transplantation in pediatric patients

Yüksel, Muhammed; Demir, Başar; Mizikoglu, Ozlem; Akyıldız, Murat; Baygül, Arzu; Arıkan, Çiğdem

doi:10.1111/petr.14049

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…The vitamin D status in children with CLD usually improves after LT [ 19 ]. However, vitamin D deficiency can still be detected in post-LT children during long-term follow-up [ 8 20 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

Pornsiripratharn,

Treepongkaruna,

Tangkittithaworn

et al. 2024

Pediatr Gastroenterol Hepatol Nutr

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Purpose To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. Methods A cross-sectional study was conducted. Patients aged 3–21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie’s method. Clinical and biochemical data were collected. Results We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0–11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group ( p =0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below –2.0 ( p =0.010), pre-LT hepatopulmonary syndrome ( p =0.014), elevated serum direct and total bilirubin levels ( p =0.037 and p =0.049, respectively), and vitamin D deficiency at 1-year post-LT ( p =0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below –2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49–23.76; p =0.012) for VF. All VFs in the non-LT group were reported in males. Conclusion In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below –2.0 after LT.

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“…The vitamin D status in children with CLD usually improves after LT [ 19 ]. However, vitamin D deficiency can still be detected in post-LT children during long-term follow-up [ 8 20 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

Pornsiripratharn,

Treepongkaruna,

Tangkittithaworn

et al. 2024

Pediatr Gastroenterol Hepatol Nutr

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“…Vitamin D deficiency is common due to impaired 25-hydroxylation in advanced liver disease, limited exposure to UV light, and nutritional deficiencies. A study of 135 children who underwent liver transplantation showed a mean pretransplant vitamin D level of 14 ng/ml [11 ▪▪ ]. Prolonged vitamin D deficiency leads to secondary hyperparathyroidism, increased bone turnover and accelerated decline in bone mass.…”

Section: Pre-transplant Risk Factorsmentioning

confidence: 99%

Bone health in children undergoing solid organ transplantation

Pinto,

Muzumdar,

Hecht Baldauff

2023

Current Opinion in Pediatrics

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Purpose of review Pediatric solid organ transplant recipients are a unique and growing patient population who are at risk for metabolic bone disease both before and after transplantation. Recent findings The odds of sustaining a fracture in adulthood are significantly higher if an individual has sustained at least one childhood fracture, therefore, close monitoring before and after transplant is essential. Emerging data in patients with chronic kidney disease mineral and bone disorder (CKD-MBD) and hepatic osteodystrophy highlights the role of fibroblast growth factor 23 in the pathogenesis of metabolic bone disease in these conditions. While dual X-ray absorptiometry (DXA) is the most widely used imaging modality for assessment of bone mass in children, quantitative computer tomography (QCT) is an emerging modality, especially for patients with glucocorticoid-induced osteoporosis. Summary Solid organ transplantation improves organ function and quality of life; however, bone mineral density can decline following transplantation, particularly during the first three to six months. Immunosuppressive medications, including glucocorticoids, are a major contributing factor. Following transplant, treatment should be tailored to achieve mineral homeostasis, correct nutritional deficiencies, and improve physical conditioning. In summary, early identification and treatment of metabolic bone disease can improve the bone health status of pediatric transplant recipients as they enter adulthood. Video abstract http://links.lww.com/MOP/A71

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“…Although the challenges in this vulnerable population remain unique, steroid withdrawal 48 and supplemental recombinant human growth hormone therapy 49 have been linked to positive outcomes in pediatric LT recipients, with a so-called "catch-up growth" phenomenon. Vitamin D supplementation is also recommended to correct the important insufficiency in children undergoing LT until levels are normal, 50 as fractures secondary to reduced bone mass and disorder of the bone architecture, particularly at the wrist, hip, and spine, can affect 20% to 40% of this population. 51…”

Section: Growth and Bone Developmentmentioning

confidence: 99%

Pediatric Liver Transplantation: Long-Term Follow-Up Issues

Bellini¹,

Lauro²,

D’Andrea³

et al. 2022

Exp Clin Transplant

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Pediatric liver transplant is an established life-saving procedure for children with end-stage liver diseases, achieving excellent graft and patient survival but with effects on quality of life and psychological welfare in the long-term. With the natural increase in the number of pediatric transplant patients becoming adults, it is essential to successfully plan and manage issues affecting late outcomes in the vulnerable pediatric transplant population. This study offers an overview of the long-term surgical complications, the consequences of immunosuppression (such as posttransplant diabetes, hypertension, cardiovascular disease, and renal dysfunction), and the infection and malignancy risks. Finally, because quality of life is now an inclusive measurement of patient satisfaction, guidance on how to facilitate the transition to adulthood, empowering transplant recipients, is also provided.

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Course of vitamin D levels before and after liver transplantation in pediatric patients

Cited by 5 publications

References 32 publications

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation

Bone health in children undergoing solid organ transplantation

Pediatric Liver Transplantation: Long-Term Follow-Up Issues

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