Osteoporosis in Adult Survivors of Adolescent Cardiac Transplantation May Be Related to Hyperparathyroidism, Mild Renal Insufficiency, and Increased Bone Turnover

Cohen, Adi; Addonizio, Linda J.; Lamour, Jacqueline M.; Addesso, Vicki; Staron, Ronald B.; Gao, Ping; Shane, Elizabeth

doi:10.1016/j.healun.2004.03.020

Cited by 28 publications

(18 citation statements)

References 41 publications

(48 reference statements)

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“…While osteoporosis is the most common cause of morbidity after heart transplantation, the mechanism by which it causes this morbidity is still not fully understood [12,13]. Compared with controls of concordant age and sex, bone mineral density was shown to decrease by 10-20% after the transplant [14].…”

Section: Discussionmentioning

confidence: 99%

The effect of functional performance, respiratory function and osteopenia on the quality of life after heart transplantation

Karapolat

Eyigör

Durmaz

et al. 2008

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

The effect of functional performance, respiratory function and osteopenia on the quality of life after heart transplantation

Karapolat

Eyigör

Durmaz

et al. 2008

International Journal of Cardiology

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“…This is in agreement with studies in adult transplant patients showing an association with osteoporosis and high PTH levels. (2,43,44) Vitamin D deficiency is known to cause PTH elevation in patients with good graft function, and it should be avoided. The optimal vitamin D level for risk groups is speculated to be ;80 nM, and the PTH level should be within the normal range.…”

mentioning

confidence: 99%

Bone Health in Children and Adolescents After Renal Transplantation

Valta

Mäkitie

Rönnholm

et al. 2009

Journal of Bone and Mineral Research

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ABSTRACT:The basis for lifelong bone health is established in childhood and adolescence. Whereas pediatric renal transplant (RTx) patients are at risk for impaired bone mass gain and fractures, scarce data on this subject are available. We performed a cross-sectional and longitudinal study of bone health in a national cohort of 106 pediatric RTx patients (median age, 12.6 yr; median follow-up, 5.1 yr after RTx). The patients underwent clinical evaluation, DXA for BMD, and spinal imaging for vertebral fractures. In longitudinal analysis, the median lumbar spine BMD Z-score was lowest (median, 21.0) at 1 yr postoperatively but increased to a peak value of 20.2 at 5 yr. In boys, the lumbar spine BMD Z-score increased also during puberty but decreased in girls. In cross-sectional analysis, the lumbar spine, hip, and whole body BMD Zscores were < 22 SD in 4%, 6%, and 6% of the patients, respectively. Sixteen percent had sustained peripheral fractures, and 8% had vertebral fractures. Female sex and age >15 yr (OR, 56.26; 95% CI, 5.17-611.82; p = 0.0007) as well as high plasma PTH levels (OR, 4.03; 95% CI, 1.37-11.85; p = 0.009) were significant predictors for low BMD. Three-year cumulative glucocorticoid dose, outside the immediate postRTx years, was not associated with BMD parameters. The observed BMD results were satisfactory. However, the high (8%) prevalence of vertebral fractures warrants careful evaluation of bone health in these patients.

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“…In a study on nine adult survivors of adolescent heart transplant, Cohen et al. (17) showed that bone‐specific alkaline phosphatase, serum N‐telopeptide and parathyroid hormone were significantly elevated in transplant patients compared to healthy controls. Guo et al.…”

Section: Discussionmentioning

confidence: 99%

Bone mineral status in pediatric heart transplant recipients: A retrospective observational study of an “at risk” cohort

Sachdeva¹,

Soora²,

Bryant³

et al. 2010

Pediatric Transplantation

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There is a paucity of literature assessing the burden of bone loss in PHT recipients. We sought to describe the bone mineral status in PHT recipients by doing a retrospective medical record review of those who underwent evaluation of BMD when clinically indicated. Data collected included patient demographics, BMD evaluations, serum calcium, phosphorus, alkaline phosphatase, cumulative steroid dose, osseous complications and their management. Of 149 PHT recipients, 26 underwent BMD evaluation. This evaluation was done at a median of 3.4 yrs after PHT. There total serum calcium, phosphorus and alkaline phosphatase were similar at transplant and BMD study. The median BMD Z-scores were: whole body -0.09 (1.5 to -5.13) and lumbar spine -1.1 (1.5 to -5.16). Bone loss (Z-score <-1) was present in 14 (53.8%). Three patients had spinal fractures and/or avascular necrosis of various bones. Treatment included calcitrol and bisphosphonates; and vertebroplasty for spinal fracture. Bone loss was present in a significant proportion of PHT recipients and may be associated with fractures and avascular necrosis. More than half of our "at risk" cohort had bone loss. Careful surveillance of these patients should be performed to prevent morbidity.

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Osteoporosis in Adult Survivors of Adolescent Cardiac Transplantation May Be Related to Hyperparathyroidism, Mild Renal Insufficiency, and Increased Bone Turnover

Cited by 28 publications

References 41 publications

The effect of functional performance, respiratory function and osteopenia on the quality of life after heart transplantation

The effect of functional performance, respiratory function and osteopenia on the quality of life after heart transplantation

Bone Health in Children and Adolescents After Renal Transplantation

Bone mineral status in pediatric heart transplant recipients: A retrospective observational study of an “at risk” cohort

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