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Bone loss and fracture after lung transplantation.
Shane, E; Papadopoulos, A; Staron, R B; Addesso, V; Donovan, D; McGregor, C; Schulman, L L.
Afiliação
  • Shane E; Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. es54@columbia.edu
Transplantation ; 68(2): 220-7, 1999 Jul 27.
Article em En | MEDLINE | ID: mdl-10440391
BACKGROUND: Osteoporosis is very common in patients with end-stage pulmonary disease. However, there are few prospective data on fracture incidence after lung transplantation. METHODS: We prospectively evaluated changes in bone mass, fracture incidence, and biochemical indices of bone and mineral metabolism in 30 patients who completed 1 year of observation after lung transplantation. All received calcium, vitamin D, and therapy with one or more agents that inhibit bone resorption, initiated shortly after transplantation. RESULTS: Before transplantation, only 20% of the patients had normal lumbar spine (LS) and femoral neck bone mineral density (BMD). After transplantation, 15 patients (50%) sustained significant bone loss at either the LS (-8.6+/-1.0%) or the femoral neck (-11.3+/-2.2%). Eleven (37%) patients (10 women) sustained a total of 54 atraumatic fractures. Pretransplantation LS BMD and T scores were significantly lower in those who sustained fractures (-2.809+/-0.32 versus -1.569+/-0.29; P<0.01). Fracture patients were more likely to have had pretransplantation glucocorticoid therapy (chi-square 5.687; P<0.02). The duration of pretransplantation glucocorticoid therapy was also longer in fracture patients (4.9+/-0.8 versus 1.3+/-0.4 years; P<0.001). Biochemical markers of bone resorption were significantly higher in patients who sustained bone loss and/or fractures. CONCLUSIONS: We conclude that fractures are a significant problem in the first year after lung transplantation, even in patients who receive therapy to prevent bone loss. Women with low pretransplantation BMD and a history of pretransplantation glucocorticoid therapy are at greatest risk.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoporose / Transplante de Pulmão / Fraturas Ósseas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 1999 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Osteoporose / Transplante de Pulmão / Fraturas Ósseas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 1999 Tipo de documento: Article