Prevention of Bone Loss and Fracture After Lung Transplantation

Cahill, Barbara C.; O'Rourke, Mary Kay; Parker, Seymour; Stringham, James C.; Karwande, Shreekanth V.; Knecht, Thomas P.

doi:10.1097/00007890-200110150-00012

Cited by 49 publications

(36 citation statements)

References 17 publications

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“…Approximately half of the patients were treated with bisphosphonate therapy in both groups, which did not differ between both groups. In a pilot study, aggressive antiresorptive therapy preserved or increased BMD prior to and following transplantation by administration of a bisphosphonate prior to and following transplantation, resulting in only 4% of symptomatic fractures, compared to our current study fracture rate of 8% [9]. The status of antiresorptive therapy prior to transplantation in our study is not known.…”

Section: Discussioncontrasting

confidence: 51%

Incidence of Fractures after Cardiac and Lung Transplantation: A Single Center Experience

Hariman

Alex

Heroux

et al. 2014

Journal of Osteoporosis

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Osteoporotic fractures are well-known complications of organ transplantation. Fracture rates up to 35% have been previously reported following heart and lung transplantations. Our institutional pretransplant protocols include DXA scans, vitamin D screening, and appropriate antiresorptive therapy. We aimed to assess the incidence of fragility fractures following cardiac or lung transplantation. In a retrospective study 210 electronic medical records of patients who underwent LT (110 men, 100 women) and 105 HT (88 men, 17 women) between 2005 and 2010 were analyzed. Both clinical and radiographic fractures were recorded. DXA scans were obtained immediately after transplant. 17 out of 210 LT patients (8.0%) had fractures after transplantation and 9 out of 105 HT patients (8.6%) had fractures. The median time to the first fracture was 12 months and the mean time was 18 months for both LT and HT. In the HT recipients, the median femoral neck T score was statistically lower in the fracture group versus the nonfracture group. Similar results were seen in the LT patients. Conclusion. Our findings demonstrate a much lower incidence of fractures in heart and lung transplant recipients in comparison with earlier reports. Comprehensive bone care and early initiation of antiresorptive therapy are possible contributors to these improved outcomes.

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Section: Discussioncontrasting

confidence: 51%

Incidence of Fractures after Cardiac and Lung Transplantation: A Single Center Experience

Hariman

Alex

Heroux

et al. 2014

Journal of Osteoporosis

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“…Similarly, in a prospective, uncontrolled pilot study using intravenous pamidronate in lung transplant recipients, the fracture rate decreased and bone mass preserved at 1-year posttransplantation 52. In a study of renal transplant recipients, repeated doses of intravenous pamidronate preserved vertebral BMD during treatment and 6 months after cessation of treatment 53…”

Section: Specific Types Of Osteoporosismentioning

confidence: 97%

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

Raef

Al-Bugami

Balharith

et al. 2011

Annals of Saudi Medicine

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Postmenopausal osteoporosis and osteoporosis in elderly men are major health problems, with a significant medical and economic burden. Although osteopenia and osteoporosis are more common locally than in the West, fracture rates are generally less than in Western countries. Vitamin D deficiency is common in the region and contributes adversely to bone health. Vitamin D deficiency should be suspected and treated in all subjects with ostopenia or osteoporosis. The use of risk factors to determine fracture risk has been adopted by the World Health Organization and many international societies. Absolute fracture risk methodology improves the use of resources by targeting subjects at higher risk of fractures for screening and management. The King Faisal Specialist Hospital Osteoporosis Working Group recommends screening for women 65 years and older and for men 70 years and older. Younger subjects with clinical risk factors and persons with clinical evidence of osteoporosis or diseases leading to osteoporosis should also be screened. These guidelines provide recommendations for treatment for postmenopausal women and men older than 50 years presenting with osteoporotic fractures for persons having osteoporosis—after excluding secondary causes—or for persons having low bone mass and a high risk for fracture. The Working Group has suggested an algorithm to use at King Faisal Specialist Hospital that is based on the availability, cost, and level of evidence of various therapeutic modalities. Adequate calcium and vitamin D supplement are recommended for all. Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy. Alternatives to alendronate are raloxifene or strontium ranelate. Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

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“…Many of these studies have been small and most have not been randomized or controlled (7). Beneficial effects of pamidronate on indirect parameters, such as bone mineral density (BMD), have been shown in patients undergoing heart, liver, lung and kidney transplantation (8)(9)(10)(11)(12). One investigator suggested that aledronate is efficacious in preventing the natural course of bone loss associated with LT (13).…”

Section: Introductionmentioning

confidence: 99%

Prophylactic Bisphosphonate Treatment Prevents Bone Fractures After Liver Transplantation

Bodingbauer

Wekerle

Pakrah

et al. 2007

American Journal of Transplantation

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Prevention of Bone Loss and Fracture After Lung Transplantation

Abstract: Antiresorptive therapy with a bisphosphonate decreases the fracture rate and preserves bone mass 1 year after lung transplantation. In end-stage lung disease patients with osteopenia or osteoporosis, bisphosphonate therapy should be initiated before transplant surgery is contemplated.

Cited by 49 publications

References 17 publications

Incidence of Fractures after Cardiac and Lung Transplantation: A Single Center Experience

Incidence of Fractures after Cardiac and Lung Transplantation: A Single Center Experience

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

Prophylactic Bisphosphonate Treatment Prevents Bone Fractures After Liver Transplantation

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