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Bone Disease in Patients Awaiting Liver Transplantation. Has the Situation Improved in the Last Two Decades?

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Abstract

In recent years, there has been speculation about the possibility of a reduction in the incidence of fractures after liver transplantation (LT) because of changes in the characteristics of candidates and the use of different immunosuppressive therapies. We analyzed the characteristics of LT candidates (CTC) and compared them with historical data from a group of LT candidate patients (HTC). Data from 60 CTC patients consecutively included in a screening program of metabolic bone disease were compared with data from 60 HTC patients prospectively evaluated between 1992 and 1993. In all patients, we analyzed the clinical and laboratory characteristics, bone mineral density (BMD) dual-energy X-ray absorptiometry, and skeletal fractures. Patients in the CTC group were older than patients in the HTC group. The CTC group had lower femoral neck T scores. No differences were observed between groups in the proportion of patients with osteoporosis (22 vs. 30 %, p = ns) or fractures (36 vs. 33 %, p = ns). The percentage of patients with normal BMD decreased from 38 to 20 %. 25(OH)D values were low in both groups. Only 7.5 % of the CTC patients received calcium and/or vitamin D supplementation. The prevalence of fractures among CTC patients was similar to that seen two decades ago. At present, candidates for LT are older and have lower femoral bone mass. Vitamin D deficiency remains frequent; however, calcium and/or vitamin D supplementation is uncommon.

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Acknowledgments

The authors acknowledge Ana Dura (Liver Transplant Office secretary) and Eva López (Liver Transplant Office nurse) for their support in the study.

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Authors and Affiliations

  1. Metabolic Bone Diseases Unit, Rheumatology Department, CIBERehd, Hospital Clínic, University of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain

    Ana Monegal, Pilar Peris, Andrea Cuervo, Laia Gifre & Núria Guañabens

  2. Hepatology Unit, CIBERehd, Hospital Clínic, University of Barcelona, Barcelona, Spain

    Miquel Navasa & Jordi Colmenero

  3. Nuclear Medicine Department, CIBERehd, Hospital Clínic, University of Barcelona, Barcelona, Spain

    África Muxí

Authors
  1. Ana Monegal
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  2. Miquel Navasa
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  3. Pilar Peris
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  4. Jordi Colmenero
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  5. Andrea Cuervo
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  6. África Muxí
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  7. Laia Gifre
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  8. Núria Guañabens
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Correspondence to Ana Monegal.

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The authors have stated that they have no conflict of interest.

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Monegal, A., Navasa, M., Peris, P. et al. Bone Disease in Patients Awaiting Liver Transplantation. Has the Situation Improved in the Last Two Decades?. Calcif Tissue Int 93, 571–576 (2013). https://doi.org/10.1007/s00223-013-9797-4

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  • DOI: https://doi.org/10.1007/s00223-013-9797-4

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