Purpose: Osteoporosis and fractures are prevalent in orthotopic liver transplant (OLT) recipients but data on these skeletal complications are scarce in patients with end-stage liver disease awaiting liver transplantation. The aim of our study was to evaluate the prevalence of osteoporosis and vertebral fractures at screening for OLT, to determine risk factors for skeletal pathology and to evaluate the predictive value of BMD for fracture risk in these patients.
Methods: Consecutive liver transplant recipients at the Leiden University Medical Centre between 2000 and 2011 who had BMD and conventional radiographs of the spine at time of screening for OLT were studied. Clinical, laboratory and BMD data were extracted from electronic hospital records. Spinal radiographs were assessed for vertebral fractures by two independent observers using the Genants semi-quantitative method.
Results: 183 patients (median age 52 years, 74% men) were studied. Most common liver pathology was viral and alcoholic liver disease (both 28%). Osteoporosis and osteopenia were prevalent in respectively 19 and 37% at the lumbar spine and in 10 and 43% at the femoral neck. Vertebral fractures were prevalent in 56% of patients, mainly grade one fractures. Men had increased fracture risk. There was no association between any other potential risk factor studied including BMD and fracture risk.
Conclusions: Low bone mass and vertebral fractures are prevalent at time of screening for OLT but none of several potential risk factors examined, other than male gender, was predictive for increased fracture risk.
17 May 2014 - 20 May 2014