High incidence of vertebral osteoporotic fracture within the first year after liver transplantation

Abstract

Objectives: Bone loss is a complication for patients with liver diseases and after transplantation, which results in increased fracture risk. The aim of this study was to determine the incidence of osteoporotic vertebral fractures following liver transplantation.

Methods: We performed a prospective study of patients who were awaiting liver transplantation. Patients were seen at baseline (visit 1) and one year after transplantation (visit 2). At each visit, risk factors of osteoporosis were collected, biochemical tests were performed and bone mineral density with Vertebral Fracture Assessment was assessed.

Results: One hundred and fifteen patients were in the pre-transplant group and 33 patients were in the post-transplant group. In the pre-transplant group, the prevalence of vertebral fractures was 23.5%. The prevalence of densitometric osteoporosis was higher at the lumbar spine than at the femoral neck. In the post-transplant group, the prevalence of vertebral fractures at visit 1 and visit 2 was 33.3% and 60.6% respectively with an incidence of 23.1 fractures per 100 patient-years.

Conclusions: Bone fragility was highly prevalent before transplantation and worsens one year after transplantation. Bone status should be evaluated in patients with liver diseases before transplantation to identify patients at high risk of fracture and help clinicians to prescribe appropriate preventive care.