Early increase in plasma parathyroid hormone levels following liver transplantation.

Abstract:

BACKGROUND/AIMS:The pathogenesis of post-transplantation bone loss is poorly understood, although glucocorticoid therapy is believed to play an important role. In the present study we have measured plasma parathyroid hormone concentrations in the first few months after orthotopic liver transplantation, in order to examine the potential contribution of hyperparathyroidism to bone disease. PATIENTS AND METHODS:Twenty-seven patients aged 32-54 years, 12 male, undergoing liver transplantation were studied prospectively before and for 3 months after operation. Plasma parathyroid hormone and serum 25-hydroxyvitamin D concentrations were measured by radioimmunoassay. RESULTS:Plasma parathyroid hormone levels were normal in all but two patients prior to transplantation. There was a highly significant increase in plasma parathyroid hormone concentrations at 1 and 2 months (p < 0.0005 and 0.001, respectively, versus baseline); by 3 months, values were close to those obtained preoperatively. Serum 25-hydroxyvitamin D concentrations showed no significant change over the study period. However, 74% of the patients had subnormal values at baseline. CONCLUSIONS:An early and transient increase in plasma parathyroid hormone after liver transplantation may be responsible for the high rates of bone loss which occur during the first few post-operative months. Prevention of post-transplantation bone disease is most likely to be achieved by peri-operative intervention with an anti-resorptive agent.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Compston JE,Greer S,Skingle SJ,Stirling DM,Price C,Friend PJ,Alexander G

doi

10.1016/s0168-8278(96)80243-1

subject

Has Abstract

pub_date

1996-11-01 00:00:00

pages

715-8

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(96)80243-1

journal_volume

25

pub_type

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