Bone Loss After Liver Transplant

A drug used to treat osteoporosis, when used in combination with calcium and vitamin D, can prevent the additional bone loss that commonly occurs after liver transplants, according to a study appearing in the August 2005 issue of Liver Transplantation.

Osteoporosis often occurs in patients with end-stage liver disease and can be worsened by the immunosuppressive drugs given to prevent rejection following transplantation. Researchers assessed osteoporosis in 136 pre-liver-transplant patients between January 1999 and December 2003 at Innsbruck Medical University (Austria). All patients on the list were given 1,000 mg of calcium and 400 IE of vitamin D daily. In addition, bisphosphonate (alendronate) was given following liver transplant to those patients who had either osteopenia or osteoporosis. Patients whose bone mineral density (BMD) decreased following transplant were also given biophosphonate.

"The striking result of this study was that alendronate combined with calcium and vitamin D almost completely prevented further bone loss in the first four months after liver transplant,” observed the researchers, led by Gunda Millonig of the department of gastroenterology and hepatology at Innsbruck Medical University. "This is a significant improvement compared to the natural course of bone loss within the first few months after liver transplant.”

In addition, patients with osteopenia and osteoporosis, who accounted for 72% of the patients in the study, remained stable on the alendronate therapy for the first four months after transplant and showed improved BMD over the next three years, although their BMD never reached normal levels. The researchers conclude that while the results were promising, further randomized studies are needed.




Related Links:
U. of Innsbruck