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KMID : 0361120110250040249
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Korean Journal of Transplantation
2011 Volume.25 No. 4 p.249 ~ p.256
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The Characteristics and Treatment of Bone Loss after Liver Transplant
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Jung Ji-Woong
Kim Hye-Young
Park Min-Su
Choi Young-Rok
Hong Geun
Jeon Young-Min
Yi Nam-Joon
Lee Kwang-Woong
Suh Kyung-Suk
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Abstract
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Background: Bone loss after liver transplant (LT) is a long-term problem associated with an increased morbidity due to
pathologic fractures. We reviewed our management of post-LT bone loss.
Methods: We collected retrospective data from 82 adult LT recipients between January 2006 and December 2009 who had
preoperative and postoperative (12 to 24 months) bone mineral density (BMD) data measured by dual energy X-ray
absorptiometry (DXA). BMD was decreased in 52 out of 82 patients before LT. These patients were managed with calcium
plus alendronate, calcium only, or no treatment. We compared the efficacy of these three modalities and the factors
influencing BMD changes and investigated the incidence of pathologic fractures.
Results: In decreased BMD patients (n=52), the postoperative spinal BMD was increased with all three treatment modalities.
A more significant increase was found with ALN treatment (+0.103) compared to NO treatment (+0.029) (P-value: 0.016).
However, femoral BMD decreased despite ALN treatment. Alendronate use was a significant factor for post-LT spinal BMD
improvement in the univariate and multivariate analysis. There were significant newly-developed pathologic fractures after
LT especially in osteoporotic patients (28%).
Conclusions: Weekly alendronate with daily calcium may be helpful for the spinal bone mineral protection in preoperative
patients with decreased BMD.
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KEYWORD
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Liver transplantation, Osteoporosis, Bone density, Born fractures, Alendronate
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