A new study on bone loss in patients with liver disease before and after transplant found that those with the lowest bone density before transplant showed the most improvement afterwards. It also showed that bone loss immediately following transplant was common and identified several risk factors for post-transplant bone loss.
The results of this study appear in the September 2006 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS). The journal is published on behalf of the societies by John Wiley & Sons, Inc. and is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/livertransplantation.
Osteoporosis and osteopenia, its less severe form, are known complications of cirrhosis, especially in patients with cholestatic liver disease (where bile production stops). However, the underlying mechanism of bone loss in these patients is poorly understood and osteoporosis is often overshadowed by the more pressing health problems seen with liver disease. Early aggressive bone loss occurs in almost all patients following transplant, and although immunosuppression is assumed to play a role in bone loss, risk factors have not been well established to date.
In the largest cohort of patients reported to date that were transplanted at a single center, Maureen M. J. Guichelaar of the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, MN and her colleagues studied 360 adult patients undergoing liver transplants at the Mayo Clinic between 1985 and 2001. All of the patients were diagnosed either with end-stage primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC), where the bile ducts become inflamed and obstructed, causing bile to build up in the liver and damage it. Patients
Contact: David Greenberg
John Wiley & Sons, Inc.