Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;104(7):599-606.
doi: 10.1093/qjmed/hcr025. Epub 2011 Mar 8.

Fracture incidence after liver transplantation: results of a 10-year audit

M O Premaor  1 , T K Das, I Debiram, R A Parker, M Ninkovic, G T Alexander, J E Compston
Affiliations

Fracture incidence after liver transplantation: results of a 10-year audit

M O Premaor et al. QJM. 2011 Jul.

Abstract

Background: High rates of fracture following liver transplantation were reported in earlier years, but the impact of subsequent changes in immune suppression and the introduction of bone-protective therapy on fracture rate have not been reported.

Aim: The aim of this study was to document clinical fracture incidence during the period 1998-2008 in a single transplant centre, following the introduction of a bone management protocol.

Design: It was designed as a retrospective cohort.

Methods: Records were retrieved from 531 of 592 eligible patients in an audit of all patients undergoing a first liver transplant during the 10-year period. All fractures were verified radiologically.

Results: The mean follow-up period was 61.4 months. Prior to transplantation 5.6% of patients had a history of fracture. Incident clinical fractures following transplantation were recorded in just 15 (3.5%) patients. The most common fracture site was the spine and the median time from transplant to fracture was 26 months (range 2-83 months).

Conclusion: There was a low fracture rate in patients undergoing liver transplantation in this centre over the past 10 years. This rate is lower than that in previous reports, which is likely to reflect the use of lower doses of prednisolone for immune suppression and the administration of bone-protective therapy to high-risk patients.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Incidence of fracture after the orthotopic liver transplant.
Figure 2.
Figure 2.
Lumbar spine (a) and total hip (b) BMD T-score before and after liver transplant (n = 52).
See this image and copyright information in PMC

References

    1. Compston JE. Osteoporosis after liver transplantation. Liver Transplant. 2003;9:321–30. - PubMed
    1. Weaver GA, Franck WA, Streck WF, Starzl TE. Hepatic osteodystrophy after liver transplantation in a patient with primary biliary cirrhosis. Am J Gastroenterol. 1983;78:102–6. - PubMed
    1. Haagsma EB, Thijn CJP, Post JG, Slooff MJH, Gips CH. Bone disease after orthotopic liver transplantation. J Hepatol. 1988;6:94–100. - PubMed
    1. Porayko MK, Wiesner RH, Hay JE, Krom RAF, Dickson ER, Beaver S, et al. Bone disease in liver transplant recipients: incidence, timing, and risk factors. Transplant Proc. 1991;23:1462–5. - PubMed
    1. Eastell R, Dickson ER, Hodgson SF, Wiesner RH, Porayko MK, Wahner HW, et al. Rates of vertebral bone loss before and after liver transplantation in women with primary biliary cirrhosis. Hepatology. 1991;14:296–300. - PubMed

Publication types

Substances