Pyridoxal-5′-phosphate deficiency after intestinal and multivisceral transplantation

Matarese, Laura E.; Dvorchik, Igor; Costa, Guilherme; Bond, Geoffrey; Koritsky, Darlene; Ferraris, Ronaldo P.; Touger‐Decker, Riva; O’Sullivan-Maillet, J.; Abu‐Elmagd, Kareem

doi:10.3945/ajcn.2008.26898

Cited by 18 publications

(13 citation statements)

References 31 publications

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“…The results suggested that about 11% who took a daily supplement and 25% who did not take any supplement have a P5P level of less than 20 nmol/L [30]. Recently, Matarese et al reported a high incidence of vitamin B6 deficiency following small bowel and multivisceral transplantatioñ 96% [11]. Variable degrees of deficiencies have also been reported in liver transplantation (60%) [31], renal transplantation 50% [32], and cardiac transplantation 20% in [12].…”

Section: Water Soluble Vitaminsmentioning

confidence: 90%

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Vitamins Status Following Solid Organ Transplantation

Shawaqfeh¹

2015

J Mol Biomark Diagn

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Solid organ transplantation is a popular solution for many end stage organ failures. The functional evaluation of these transplanted organs is multi-factorial and involves many aspects involving organ function, overall patient wellbeing and quality of life. Literature reports on vitamin status following transplantation had been collected together in this review article. This review summarizes the current status of research in this area with focus on reported deficiencies in vitamins following solid organ transplantation. The deficiencies in either fat-soluble vitamins like vitamin D, vitamin A and vitamin K as well as water soluble vitamins like vitamin B6, vitamin B12 and thiamine have been summarized. The reported deficiencies are noteworthy and necessitate a critical evaluation and interventions in many transplantation programs

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Section: Water Soluble Vitaminsmentioning

confidence: 90%

“…Vitamin B6 deficiency was significant following intestinal transplantation and to lesser extent in kidney, liver and cardiac transplantation. [11,12]. Similarly, acute folic acid deficiency was observed after bone marrow transplantation [13].…”

Section: Vitamin K Livermentioning

confidence: 96%

Vitamins Status Following Solid Organ Transplantation

Shawaqfeh¹

2015

J Mol Biomark Diagn

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“…After recovery of the intestinal allograft absorptive functions, heparin treatment was replaced with oral warfarin. Full details of pre- and postoperative management is described elsewhere 3,6,9–11 .…”

Section: Methodsmentioning

confidence: 99%

“…Such an assumption stemmed from the previously acknowledged deleterious metabolic effects of HPN, gut failure, primary gastrointestinal diseases and other concomitant systemic disorders 4,5 . In addition, the high allointestine immunogenicity and the lack to achieve full nutritional autonomy in all recipients may play a major role in the early and late deterioration of bone health after transplantation 3,6 .…”

Section: Introductionmentioning

confidence: 99%

Skeletal Integrity and Visceral Transplantation

Resnick¹,

Gupta²,

Wagner³

et al. 2010

American Journal of Transplantation

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Despite continuous improvement in long-term survival, there is no knowledge about risk of bone health impairment and management strategies before and after intestinal transplantation. Therefore, 147 adults were retrospectively studied via chart review; 70 long-term survivors, 53 candidates and 24 recipients with longitudinal follow-up. Evaluation process included measurement of bone mineral density (BMD) and allied biochemical markers. Both long-term survivors and candidates showed low bone mass with lower (p < 0.05) z-scores at hip, femoral neck and spine. Vitamin D deficiency and secondary hyperparathyroidism were observed in both groups. Prevalence of osteoporosis was 44% among long-term survivors and 36% in candidates with age, BMD, duration of parenteral nutrition, type of immunosuppression and rejection being significant risk factors. Fragility fractures occurred at a higher (p = 0.02) rate among long-term survivors (20%) compared to candidates (6%). The longitudinal study documented acceleration (p = 0.025) of bone loss after transplantation with a decline of 13.4% (femoral neck), 12.7% (hip) and 2.1% (spine). Alendronate reduced (p < 0.05) but did not prevent bone loss. In conclusion, intestinal transplant recipients are at risk of osteoporosis secondary to bone loss before and after transplantation. Accordingly, current management includes comprehensive preventive measures with prompt therapeutic intervention utilizing intravenous bisphosphonates or subcutaneous human PTH 1–34.

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“…There are several risk factors of vitamin B6 inadequacy in allograft recipients including, among others, allograft dysfunction, diarrhea, catabolic state, and usage of medications altering vitamin B6 metabolism or absorption [5]. In a previous study we showed that immunosuppressive treatment may influence pyridoxine status in kidney transplant recipients [6].…”

mentioning

confidence: 98%