Prevalence and Characteristics of Bone Disease in Cirrhotic Patients Under Evaluation for Liver Transplantation

Vargas, Alfonso; Acevedo, Juan Manuel Pascasio; Domingo, Ignacio Gutiérrez; Jiménez, Rosario García; Martín, Jesús; Ríos, M.T. Ferrer; Mota, Manoela; Gallego, Álvaro Giráldez; Bravo, Miguel Ángel Gómez

doi:10.1016/j.transproceed.2012.05.011

Cited by 38 publications

(20 citation statements)

References 13 publications

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“…Leptin also causes to receptor activator of nuclear factor kappa-B ligand (RANKL) production inhibition and diminishing bone resorption. Patients with cholestatic liver disease also show decreased leptin levels (23)(24)(25). The prevalence of bone fractures was 20.8% in primary biliary cirrhosis patients (26).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of mandibular inferior cortex changes in patients candidate for liver and kidney transplantation using panoramic view

Ghapanchi¹,

Haghnegahdar²,

Faghih³

et al. 2017

J Nephropathol

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Section: Discussionmentioning

confidence: 99%

Evaluation of mandibular inferior cortex changes in patients candidate for liver and kidney transplantation using panoramic view

Ghapanchi¹,

Haghnegahdar²,

Faghih³

et al. 2017

J Nephropathol

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“…In addition, direct detrimental effects of alcohol, iron, and corticosteroids in patients with autoimmune liver disease have been implicated. The molecular mechanisms have not been elucidated; however, it is possible that circulating cytokines and growth factors involved in liver regeneration and repair may also modulate bone turnover (1,2,3,4). …”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of bone disease has been reported in previous studies to range between 12% and 55% among patients with liver cirrhosis (1,2,3,4). Following liver transplantation (LT), the fracture risk is further increased due to the use of high steroid doses and prolonged immobility, particularly when complications arise after surgery.…”

Section: Introductionmentioning

confidence: 93%

Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

Erhamamci¹,

Aktaş²,

Bahçeci³

et al. 2013

MIRT

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Objective: End-stage chronic liver disease (CLD) adversely affects the function of multiple organ systems including the skeletal system. The aim of this study was to assess osseous and nonosseous bone scintigraphy (BS) findings in liver transplant (LT) candidates with end-stage CLD.Methods: We retrospectively evaluated BS findings in 50 consecutive patients with end-stage CLD who were undergoing preoperative assessment for LT from January 2006 to December 2011. All the patients were analyzed with respect to clinical and laboratory parameters, and BS findings. Scintigrams were visually assessed for the presence of osseous and nonosseous abnormalities. Osseous abnormalities were classified as those indicating bone metabolism changes or metastatic bone disease. Typical scintigraphic findings denoting to changes in bone metabolism were the presence of decreased osseous uptake, increased periarticular uptake, asymmetrical or unusual uptake patterns. Nonosseous findings were classified according to the degree of soft-tissue uptake as mild and severe.Results: The group consisted of 46 adult and 4 adolescent patients. All adolescent patients had normal skeletal accumulation with growth plate uptake and one had mildly increased renal cortical activity. A total of 46 adult patients had one or more of the following osseous findings: generalized decrease in osseous uptake (n=4, 8.7%); bilateral decrease in lower extremity uptake (n=26, 56.5%); symmetrically increased periarticular uptake (n=26, 56.5%); bilateral cortical/periosteal increased uptake in the lower extremity indicating hepatic hypertrophic osteoarthropathy (HOA) (n=8, 17.4%); bilateral increased sacroiliac activity (n=16, 34.8%); sacral activity (n=10, 21.7%), coccygeal activity (n=2, 4.3%), focally increased uptake suggestive of metastases (n=5, 10.9%). Three rib metastases appeared to be linear. Nonosseous findings observed in adult patients were mild diffuse liver uptake (n=4, 8.7%) and bilateral diffuse mild or severe degree of renal cortical uptake (n=20, 43.5%). There was a statistically significant difference in serum creatinine values between mild and severe renal uptake groups (p<0.05). There was also statistically significant difference in serum BUN and creatinine values between patients with severe degree of renal uptake and without renal uptake (p<0.05).Conclusion: The results of the current study has shown that adolescent LT candidates with end-stage CLD had no osseous abnormality on BS. However, all of adult patients exhibited one or one more osseous abnormalities. Typical scintigraphic findings denoting to abnormalities in bone metabolism were generalized decreased osseous uptake, decreased lower extremity osseous uptake, increased periarticular uptake, increased cortical/periosteal uptake indicating hepatic HOA, and other unusual uptake patterns. Hepatocellular carcinoma metastases may present itself as rib metastases linear in pattern. Soft-tissue uptake in the form of diffuse bilateral mild or severe degree of renal uptake and less commonly mil...

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“…In particular, patients receiving glucocorticoids and/or those submitted to liver transplantation suffer an additional decrease in their bone mass due to the use of immunosuppressant drugs. Therefore, some authors have advocated that bone densitometry must be part of the evaluation performed before orthotopic liver transplantation (OLT) [2, 7]. Furthermore, recent data have suggested that bone status must be assessed in all cirrhotic patients [8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…Then, other studies assessed patients before and after OLT [16, 17]. Most of them have shown that osteoporosis is common among all cirrhotic patients regardless of the liver disease etiology or the degree of liver impairment [7, 9, 18, 19]. Thus, the aim of this review was to evaluate the physiopathology, the impact, the diagnosis, and the management of osteoporosis in patients with liver cirrhosis, in order to show the more recent data and establish some comparisons between cirrhotic patients under different conditions.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Cirrhosis-Related Osteoporosis

Santos

Romeiro

2016

BioMed Research International

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Management of cirrhosis complications has greatly improved, increasing survival and quality of life of the patients. Despite that, some of these complications are still overlooked and scarcely treated, particularly those that are not related to the liver. This is the case of osteoporosis, the only cirrhosis complication that is not solved after liver transplantation, because bone loss often increases after immunosuppressant therapy. In this review, the definitions of bone conditions in cirrhotic patients are analyzed, focusing on the more common ones and on those that have the largest impact on this population. Risk factors, physiopathology, diagnosis, screening strategies, and treatment of osteoporosis in cirrhotic patients are discussed, presenting the more striking data on this issue. Therapies used for particular conditions, such as primary biliary cirrhosis and liver transplantation, are also presented.

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Prevalence and Characteristics of Bone Disease in Cirrhotic Patients Under Evaluation for Liver Transplantation

Cited by 38 publications

References 13 publications

Evaluation of mandibular inferior cortex changes in patients candidate for liver and kidney transplantation using panoramic view

Evaluation of mandibular inferior cortex changes in patients candidate for liver and kidney transplantation using panoramic view

Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

Diagnosis and Management of Cirrhosis-Related Osteoporosis

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