Clin Osteol 2015; 20(2): 40-44
Transplantácia pečene a kostná denzitaOriginal contributions
Background: Decreased bone density and fractures are frequent complications of liver cirrhosis, playing an important role in patients not only prior to but also after orthotopic liver transplantation (OLT).
Objectives: The objective was to retrospectively analyze a group of patients to determine bone density status, selected laboratory parameters and X-ray of the spine at one year after OLT and to compare them with a group of patients who were not transplanted.
Material and Methods: The group comprised 51 patients (37 males, 14 females) with liver cirrhosis. The age range was 38-63 years; the mean age was 50 years. Bone density was measured using the DXA method at the lumbar spine, femoral neck and hip. The laboratory parameters included calcium, albumin and total 25-hydroxyvitamin D (25-OH D) levels. X-rays of the thoracic and lumbar spine were obtained. The data were processed using Student?s t-test with statistical significance p < 0.05.
Results: In the lumbar spine region, bone density was statistically significantly increased in post-transplantation patients as compared with patients who were not transplanted (p < 0.02). Bone density in the hip and femoral neck regions was insignificantly decreased in patients at one year after OLT and significantly increased in those who were not transplanted (p < 0.001; p < 0.04). Calcium levels were not significantly changed in either of the groups. The mean level of 25-OH D increased in patients after OLT as compared with those who did not undergo OLT. Prior to transplantation, only 4 patients had normal 25-OH D levels and the others had low levels of 25-OH D. After transplantation, normal vitamin D levels were found in 22 patients and low levels in 14 patients. In patients after OLT, the mean albumin level rose to normal values; patients without OLT had unchanged albumin levels. No new fractures in the area of the thoracic and lumbar spine were observed in patients after OLT. Two patients without transplantation had fractures in the thoracic spine region.
Conclusions: It was found that as early as one year after liver transplantation, patients had better bone density in the lumbar spine region and normalized laboratory parameters. OLT combined with sufficient calcium and vitamin D supplementation leads to improved bone density and subsequent fracture risk reduction.
Keywords: liver transplantation, liver cirrhosis, osteoporosis, densitometry
Published: December 11, 2015 Show citation
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