Bone fractures after cardiac transplantation.

Abstract:

OBJECTIVE:Bone loss and bone fractures are disabling complications after heart transplantation. Severe bone loss happens mainly during the first year posttransplantation. Steroids and cyclosporine alter bone metabolism in several ways. To counterbalance these effects, antiresorptive therapy is provided to these patients. The objective of this study was to assess the frequency of bone fractures after heart transplantation, considering previous comorbidities, immunosuppressive therapy, and osteoprotective treatment. METHODS:From 1993 to 2005, 443 consecutive heart transplant recipients were followed for the occurrence of bone fractures, immunosuppressive therapy, clinical conditions, and antiresorptive treatment. RESULTS:There were 41 fractures in 34 patients (7.6%, group I). The remainder of patients formed group II. Fractures commonly involved the lumbar spine. Postmenopausal women had more fractures than other patients (20.6% vs 7.8%, P = .02). When the initial immunosuppressive regimen included tacrolimus, fractures did not happen (P = .01, vs other regimens). Osteoprotective therapy was administered to 91.2% of patients in group I and 79% in group II (P = .08). Mean interval from transplantation to the first fracture was 1131.5 days. Overweight patients had a 61.8% incidence of fracture. CONCLUSIONS:Our series showed a low frequency of bone fractures. Postmenopausal women and overweight patients had more fractures. An initial immunosuppressive regimen using tacrolimus was associated with lower fracture rates.

journal_name

Transplant Proc

authors

Luaces M,Crespo Leiro MG,Paniagua Martin MJ,de Lara JG,Rivas RM,Piñon Esteban P,Cursak G,Ríos R,Leira CN,Alonso JJ,Beiras AC

doi

10.1016/j.transproceed.2007.07.063

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

2393-6

issue

7

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)00897-4

journal_volume

39

pub_type

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