High risk of osteoporosis and fracture following solid organ transplantation: a population-based study

Chen, Hsin; Lai, Yung‐Rung; Yang, Yih; Gau, Shuo‐Yan; Huang, Cheng-Yang; Tsai, Tung-Han; Huang, Kuang‐Hua; Lee, Chien‐Ying

doi:10.3389/fendo.2023.1167574

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…While osteoporosis is common among patients awaiting transplantation, further bone loss is a typical phenomenon throughout the early posttransplant period [11]. Even patients without a pretransplant history of osteoporosis face an elevated risk of posttransplant osteoporosis and fractures [12,13]. The incidence of fractures is four to five times higher compared to the general population [14,15] and can be attributed, in part, to the side effects of immunosuppressive agents such as glucocorticoids, cyclosporine A, and tacrolimus [16][17][18][19].…”

Section: Musculoskeletal Injuriesmentioning

confidence: 99%

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Stylemans,

Vandecruys,

Leunis

et al. 2024

Transpl Int

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An increasing body of randomized controlled trials suggests the safety of engaging in moderate to vigorous intensity exercise training following solid organ transplantation. Fueled by emerging sport events designed for transplant recipients and the ever-growing body of research highlighting the diverse health benefits of physical activity, transplant recipients are now increasingly participating in strenuous and occasionally competitive physical endeavors that largely surpass those evaluated in controlled research settings. This viewpoint article adopts a cautionary stance to counterbalance the prevalent one-sided optimistic perspective regarding posttransplant physical activity. While discussing methodological limitations, we explore plausible adverse impacts on the cardiovascular, immunological, and musculoskeletal systems. We also examine the physiological consequences of exercising in the heat, at high altitude, and in areas with high air pollution. Risks associated with employing performance-enhancing strategies and the conceivable psychological implications regarding physical activity as a tribute to the ‘gift of life’ are discussed. With a deliberate focus on the potential adverse outcomes of strenuous posttransplant physical activity, this viewpoint aims to restore a balanced dialogue on our comprehension of both beneficial and potentially detrimental outcomes of physical activity that ultimately underscores the imperative of well-informed decision-making and tailored exercise regimens in the realm of posttransplant care.

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Section: Musculoskeletal Injuriesmentioning

confidence: 99%

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Stylemans,

Vandecruys,

Leunis

et al. 2024

Transpl Int

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Multiple fractures after low-energy trauma in an immunosuppressed lung transplant patient with severe osteoporotic bone texture—a challenge for traumatology and osteology

Andresen,

Direder,

Widhalm

2024

Journal of Surgical Case Reports

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Patients before and after lung transplantation often have osteoporosis with existing and recent symptomatic insufficiency fractures, which reduce the quality of life and increase general morbidity and mortality. Due to the reduced bone quality with a significantly increased fracture risk, even low-energy trauma results in the risk of acquiring multiple and complex fractures. The rarefied bone substance can be very challenging for subsequent osteosynthetic treatment. Antiosteoporotic medication is always necessary, and osteoanabolic therapy should be discussed in such cases. In the following, we report about the successful osteosynthetic treatment of an immunosuppressed patient with multiple fractures after a fall from low height. To support fracture healing with antiosteoporotic drug therapy, the patient was switched from antiresorptive to osteoanabolic medication, which resulted in complete fracture consolidation over the course of 6 months. There were also no new insufficiency fractures during this period; however, no improvement in bone density was achieved.

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Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations

Kim,

Ha,

Kim

et al. 2024

Endocrinol Metab

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This review article investigates solid organ transplantation-induced osteoporosis, a critical yet often overlooked issue, emphasizing its significance in post-transplant care. The initial sections provide a comprehensive understanding of the prevalence and multifactorial pathogenesis of transplantation osteoporosis, including factors such as deteriorating post-transplantation health, hormonal changes, and the impact of immunosuppressive medications. Furthermore, the review is dedicated to organ-specific considerations in transplantation osteoporosis, with separate analyses for kidney, liver, heart, and lung transplantations. Each section elucidates the unique challenges and management strategies pertinent to transplantation osteoporosis in relation to each organ type, highlighting the necessity of an organ-specific approach to fully understand the diverse manifestations and implications of transplantation osteoporosis. This review underscores the importance of this topic in transplant medicine, aiming to enhance awareness and knowledge among clinicians and researchers. By comprehensively examining transplantation osteoporosis, this study contributes to the development of improved management and care strategies, ultimately leading to improved patient outcomes in this vulnerable group. This detailed review serves as an essential resource for those involved in the complex multidisciplinary care of transplant recipients.

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High risk of osteoporosis and fracture following solid organ transplantation: a population-based study

Cited by 3 publications

References 56 publications

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Physical Exercise After Solid Organ Transplantation: A Cautionary Tale

Multiple fractures after low-energy trauma in an immunosuppressed lung transplant patient with severe osteoporotic bone texture—a challenge for traumatology and osteology

Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations

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