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. 2020 Apr 20;20(1):54.
doi: 10.1186/s12902-020-0533-6.

Endocrine disorders after heart transplantation: national cohort study

Matej Rakusa  1   2 , Bojan Vrtovec  2   3 , Gregor Poglajen  2   3 , Andrej Janez  1   2 , Mojca Jensterle  4   5
Affiliations

Endocrine disorders after heart transplantation: national cohort study

Matej Rakusa et al. BMC Endocr Disord. .

Abstract

Background: Endocrine disorders in patients after heart transplantation (HT) remain understudied. We aimed to assess endocrine profiles and management of HT recipients in the early post- transplant period.

Methods: We conducted a retrospective cohort study on 123 consecutive HT recipients in the Advanced Heart Failure and Transplantation Programme between 2009 and 2018. All recipients had per-protocol endocrine follow-up within the first postoperative year. The median time to first post-transplant endocrine follow-up was 3 months (IQR 2-4). We assessed the incidence of vitamin D deficiency, bone mineral density, history of low energy fractures, hypogonadism in male recipients, posttransplant diabetes mellitus, and thyroid and parathyroid function.

Results: We enrolled 22 women and 101 men of median age 57 years (IQR 50-63). Post-transplant diabetes mellitus developed in 14 patients (11.4%). 18 of 25 patients (14.6%) with preexisting type 2 diabetes mellitus required intensification of antidiabetic therapy. 38 male patients (40.4%) had hypogonadism. 5 patients (4.6%) were hypothyroid and 10 (9.3%) latent hyperthyroid. Secondary hyperparathyroidism was present in 19 (17.3%), 25-hydroxyvitamin D deficiency in 64 (54.7%) of patients. Osteoporosis was present in 26 (21.1%), osteopenia in 59 (48.0%) patients. 47 vertebral fractures, 3 hip and 1 humerus fractures occurred in 21 patients. Most of the patients had coincidence of two or three disorders, while less than 5% did not have any endocrine irregularities. All patients received calcium and vitamin D supplements. Forty-six patients (37.4%) were treated with zoledronic acid, 12 (9.8%) with oral bisphosphonates. Two patients were treated with teriparatide.

Conclusions: The prevalence of multiple endocrine disorders early after heart transplantation is high. Assessment and management of increased fracture risk and all other potentially affected endocrine axes should be considered as a standard of care in this early period.

Keywords: Endocrine disorders; Heart transplantation; Multiple endocrine disorder; Osteoporotic fractures.

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Conflict of interest statement

MR, BV, GP, AJ and MJ have no competing interests.

Figures

Fig. 1
Fig. 1
Coincidence of endocrine disorders. 25OHD – 25 hydroxyvitamin D; BMD – bone mineral density
See this image and copyright information in PMC

References

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