Fracture after cardiac transplantation: a prospective longitudinal study.

Shane, Elizabeth; Rivas, Maria del Carmen; Staron, Ronald B.; Silverberg, Shonni J.; Seibel, Markus J.; Kuiper, Jan Herman; Mancini, Donna; Addesso, Vicki; Michler, Robert E.; Factor-Litvak, Pam

doi:10.1210/jcem.81.5.8626827

Cited by 59 publications

(68 citation statements)

References 34 publications

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“…In cardiac transplant recipients prevalence has varied from 18 to 50%, 13 and after liver transplantation the fracture rate may be even higher. 14 A fracture rate of 9-16% in the present study seems to be lower than in association with other organ transplants.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin

Välimäki

Kinnunen

Volin

et al. 1999

Bone Marrow Transplant

110

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Summary:Transplantation of solid organs including heart, kidney, and liver is associated with rapid bone loss and increased rate of fracture; data on bone marrow transplantation recipients (BMT) are scarce. The purpose of the present study was to examine the magnitude, timing, and mechanism of bone loss following allogeneic BMT, and to study whether bone loss can be prevented by calcium with or without calcitonin. Sixty-nine patients undergoing allogeneic BMT for malignant blood diseases were enrolled into the study. Forty-four (22 women, 22 men) completed 6 months, and 36 patients 1 year follow-up. They were randomized to receive either no additional treatment (n ‫؍‬ 22), or oral calcium 1 g twice daily for 12 months (n ‫؍‬ 12) or the same dose of calcium plus intranasal calcitonin 400 IU/day for the first month and then 200 IU/day for 11 months (n ‫؍‬ 10). Bone mineral density (BMD) at the lumbar spine and three femoral sites (femoral neck, trochanter, Ward's triangle) was measured by dual-energy X-ray absorptiometry (DXA). Bone turnover rate was followed with markers of bone formation and resorption (serum bone-specific alkaline phosphatase (B-ALP), type I procollagen carboxyterminal (PICP) and aminoterminal propeptide (PINP), serum type I collagen carboxyterminal telopeptide (ICTP)). Serum testosterone was assayed in men. Calcium with or without calcitonin had no effect on bone loss or bone markers; consequently the three study groups were combined. During the first 6 post-transplant months BMD decreased by 5.7% in the lumbar spine and by 6.9% to 8.7% in the three femoral sites (P Ͻ 0.0001 for all); no significant further decline occured between 6 and 12 months. Four out of 25 assessable patients experienced vertebral compression fractures. Markers of bone formation reduced: B-ALP by 20% at 3 weeks (P ‫؍‬ 0.027), PICP by 40% (P Ͻ 0.0001) and PINP by 63% at 6 weeks (P Ͻ 0.0001), with a return to baseline by 6 months. The marker of bone resorption, serum ICTP was above normal throughout the whole observation period, with a peak at 6 weeks (77% above baseline, P Ͻ 0.0001). In male patients serum testosterone decreased reaching a nadir (57% below baseline) at 6 weeks (P ‫؍‬ 0.0003). In conclusion, significant bone loss occurs after BMT. It results from imbalance between reduced bone formation and increased bone resorption; hypogonadism may be a contributing factor in men. Bone loss can not be prevented by calcium with or without calcitonin.

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Section: Discussionmentioning

confidence: 99%

A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin

Välimäki

Kinnunen

Volin

et al. 1999

Bone Marrow Transplant

110

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“…Vertebral fractures have been reported to occur from 14 to 36% during the first post transplantation year and 22 to 35% of long-term cardiac transplant recipients (32).…”

Section: Cardiac Transplantationmentioning

confidence: 99%

Bone disease after transplantation: osteoporosis and fractures risk

Kulak

Borba

Kulak

et al. 2014

Arq Bras Endocrinol Metab

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Organ transplantation is the gold standard therapy for several end-stage diseases. Bone loss is a common complication that occurs in transplant recipients. Osteoporosis and fragility fractures are serious complication, mainly in the first year post transplantation. Many factors contribute to the pathogenesis of bone disease following organ transplantation. This review address the mechanisms of bone loss including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and management of bone loss in the transplant recipient should be included in their post transplant follow-up in order to prevent fractures. Arq Bras Endocrinol Metab. 2014;58(5):484-92Keywords Transplantation; bone loss; osteoporosis; fractures; immunosuppressive agents RESUMOTransplantes de órgão é terapia padrão-ouro para várias doenças em estágio terminal. Perda óssea é uma complicação comum que ocorre em pacientes transplantados. Osteoporose e fraturas por fragilidade são complicações sérias, principalmente no primeiro ano pós-transplante. Muitos fatores podem contribuir para patogênese da doença óssea nesses pacientes. Esta revisão aborda os mecanismos de perda óssea incluindo o papel dos agentes imunossupressores, bem como os fatores específicos da perda óssea após rim, pulmão, fígado, coração e transplante de medula óssea. A prevenção e o tratamento da perda óssea nos pacientes transplantados devem ser realizados para evitar fraturas. Arq Bras Endocrinol Metab. 2014;58(5):484-92 Descritores

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“…Figure 4 shows the bone loss from the spine of first-time user followed in longitudinal studies [9,20,25,33,38,42,51,56,67,71]. One limitation of evaluating bone loss longitudinally is that daily dose may vary and reduce over time.…”

Section: Onset Of Skeletal Effectsmentioning

confidence: 99%

The Epidemiology of Corticosteroid-Induced Osteoporosis: a Meta-analysis

Staa

Leufkens

Cooper

2002

Osteoporosis International

1,038

272

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Abstract. Studies of oral corticosteroid dose and loss of bone mineral density have reported inconsistent results. In this meta-analysis, we used information from 66 papers on bone density and 23 papers on fractures to examine the effects of oral corticosteroids on bone mineral density and risk of fracture. Strong correlations were found between cumulative dose and loss of bone mineral density and between daily dose and risk of fracture. The risk of fracture was found to increase rapidly after the start of oral corticosteroid therapy (within 3 to 6 months) and decrease after stopping therapy. The risk remained independent of underlying disease, age and gender. We conclude that oral corticosteroid treatment using more than 5 mg (of prednisolone or equivalent) daily leads to a reduction in bone mineral density and a rapid increase in the risk of fracture during the treatment period. Early use of preventive measures against corticosteroid-induced osteoporosis is recommended.

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Fracture after cardiac transplantation: a prospective longitudinal study.

Cited by 59 publications

References 34 publications

A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin

A prospective study of bone loss and turnover after allogeneic bone marrow transplantation: effect of calcium supplementation with or without calcitonin

Bone disease after transplantation: osteoporosis and fractures risk

The Epidemiology of Corticosteroid-Induced Osteoporosis: a Meta-analysis

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