Liver Transplant-Linked Bone Loss Is Temporary
Bone bounces back to pre-transplant levels over time, study finds
FRIDAY, Sept. 8, 2006 (HealthDay News) -- Liver transplant patients often lose bone mass after their operation, but bone will rebound with time, a new study shows.
The Mayo Clinic study of 360 liver disease patients also found that those with the lowest bone density before transplant had the most improvement in bone density afterward.
Loss of bone mass is a well-known complication of cirrhosis, but the underlying mechanism is poorly understood. Early, aggressive bone loss occurs in nearly all patients after liver transplant. It's believed that immunosuppression may play a role in this bone loss, but the risk factors have not been well-established, the study authors noted in the September issue of Liver Transplantation.
The team found that only 23 percent of the patients in this study had normal bone mass before their liver transplants. Four months after transplant, 51 percent had osteoporosis. However, their bone mineral density also increased for up to four years after transplant and remained above pre-transplant levels, the researchers found.
Risk factors associated with bone loss during the first four months after liver transplant were younger age at transplant, no inflammatory bowel disease before transplant; smoking; higher pre-transplant bone density; shorter duration of liver disease before transplant; and primary sclerosing cholangitis (PSC) -- a condition where the bile ducts become inflamed and obstructed, causing bile to build up in the liver and damage it.
Bone gain in the first two years after transplant was greater in patients who were pre-menopausal; had lower pre-transplant and/or four-month post-transplant bone densities; received lower doses of glucocorticoroids; and had higher blood levels of vitamin D.
Aggressive bone loss that occurred during the first four months after transplant did not change over time despite changes in immunosuppressive therapies, the study found.
The American Medical Association has more about liver transplantation.