Calcified Tissue International

, Volume 57, Issue 1, pp 15–19

Calcitonin and bisphosphonates treatment in bone loss after liver transplantation


  • M. A. Valero
    • Service of EndocrinologyUniversity Hospital
  • C. Loinaz
    • Department of SurgeryUniversity Hospital
  • L. Larrodera
    • Service of BiochemistryUniversity Hospital
  • M. Leon
    • Service of EndocrinologyUniversity Hospital
  • E. Moreno
    • Department of SurgeryUniversity Hospital
  • F. Hawkins
    • Service of EndocrinologyUniversity Hospital
Clinical Investigations

DOI: 10.1007/BF00298990

Cite this article as:
Valero, M.A., Loinaz, C., Larrodera, L. et al. Calcif Tissue Int (1995) 57: 15. doi:10.1007/BF00298990


Osteopenia is a major complication of orthotopic liver transplantation (OLT). However, no effective therapy for bone disease has been defined. We have studied vertebral bone mineral density (VMD) and fasting serum markers of bone formation [bone gla protein (BGP), procollagen I carboxyterminal peptide (PICP)] and metabolism (serum Ca, P, intact parathyroid hormone (iPTH), 25OHD3 and 1,25(OH)2D3) in 120 patents after OLT. VMD was measured by dual-energy X-ray absorptiometry (DXA) using a Hologic QDR 1000 densitometer on two occasions, 12 months apart. Patients with OLT had a VBD significantly lower compared with age- and sexed-matched Spanish controls (P<0.05). Prevalence of osteoporosis (Z score below-2 SD) was 35.8%. Serum BGP (8.6±0.7 ng/ml) and PICP (222.9±81.9 ng/dl) were higher than those of controls. However, serum calcium, phosphorus, iPTH, 25OHD3, and 1,25(OH)2D3 were within normal range. Patients with osteoporosis were randomly treated with 40 IU/day of calcitonin i.m. (Diatin, Ferrer Int. Laboratories) (n=17) or 400 mg p.o., 15 days every 3 months, of sodium ethiodronate (Difosfen, Rubio Laboratories) (n=23). All patients received 500 mg/12 hours of elemental calcium p.o. After 12 months of treatment, a significant increment of vertebral mineral density (VMD) was observed (6.4% and 8.2%, respectively). Serum BGP and PICP values remained elevated without a difference between the two drugs. Our results indicate that antiresorptive drugs may be of benefit in the high turnover osteoporosis of OLT recipients.

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© Springer-Verlag 1995