Elevated Incidence of Fractures in Solid-Organ Transplant Recipients on Glucocorticoid-Sparing Immunosuppressive Regimens. (12th September 2011)

• Record Type: Journal Article
• Authors: Edwards, B. J.; Desai, A.; Tsai, J.; Du, H.; Edwards, G. R.; Bunta, A. D.; Hahr, A.; Abecassis, M.; Sprague, S.
• Other Names: Szulc Pawel Academic Editor.
• Is Part Of: Journal of osteoporosis. Volume 2011(2011)
• Publication Date: 2011-09-12
• Subjects: Osteoporosis -- Periodicals; Osteoporosis; Orthopedic Procedures; Osteoporosis; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 616.716
• DOI: 10.4061/2011/591793
• Languages: English
• ISSNs: 2090-8059

Abstract

Abstract : This study was conducted to assess the occurrence of fractures in solid-organ transplant recipients. Methods . Medical record review and surveys were performed. Patients received less than 6 months of glucocorticoids. Results . Of 351 transplant patients, 175 patients provided fracture information, with 48 (27.4%) having fractured since transplant (2–6 years). Transplants included 19 kidney/liver (50% male), 47 kidney/pancreas (53% male), 92 liver (65% male), and 17 pancreas transplants (41% male). Age at transplant was50.8 ± 10.3 years. Fractures were equally seen across both genders and transplant types. Calcium supplementation (n = 94 ) and bisphosphonate therapy (n = 52 ) were observed, and an association with a lower risk of fractures was noted for bisphosphonate users (OR = 0.45 95% C.I. 0.24, 0.85). Fracture location included 8 (16.7%) foot, 12 (25.0%) vertebral, 3 (6.3%) hand, 2 (4.2%) humerus, 5 (10.4%) wrist, 10 (20.8%) fractures at other sites, and 7 (14.6%) multiple fractures. The estimated relative risk of fracture was nearly seventeen-times higher in male liver transplant recipients ages 45–64 years compared with the general male population, and comparable to fracture rates on conventional immunosuppressant regimens. Conclusion . We identify a high frequency of fractures in transplant recipients despite limited glucocorticoid use.