Liver transplantationCandidateBone Disorders in Patients With Chronic Liver Disease Awaiting Liver Transplantation
Section snippets
Methods
Thirty-five patients with liver cirrhosis awaiting OLT were enrolled in the study. None of the patients had a previous history of a chronic disorder associated with changes in bone metabolism: parathyroid disorder, renal failure, or prolonged immobilization in the past. None had a family history of osteoporosis, nor had they received calcium, vitamin D, or any medication that could influence bone metabolism—corticosteroids, calcitonin, hormone replacement therapy, biphosphonates,
Results
There were 27 male and 8 female patients enrolled. Seven of eight females were postmenopausal. The characteristics of the patients are shown in Table 1. Osteodystrophy was diagnosed in 14 patients (40%). No difference were observed according to gender, severity of liver disease (Child-Pugh or Model for End-stage Liver Disease [MELD]) and origin of liver disease (data not shown). Ten transplanted patients reached 3-month follow-up (Table 2); the total body T-score decreased significantly (P <
Discussion
Metabolic bone disease is a common problem in cirrhotic patients and in liver transplant recipients. Osteoporosis and related fractures are well-known complications of chronic cholestatic liver disease, with 60% of PBC and PSC patients showing osteopenia or osteoporosis before OLT.11 Bone disorders in noncholestatic liver disease have been investigated less extensively, but recent studies have suggested that patients with viral hepatitis and alcohol-related liver disease may also have decreased
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Bone Disease and Liver Transplantation: A Review
2021, Transplantation ProceedingsCitation Excerpt :The main drawback of DXA in patients with cirrhosis is that the presence of ascites could underestimate the BMD in the lumbar spine (ie, could lead to the misinterpretation that the BMD is lower to what it really is), and to avoid this error it is necessary to have a cirrhotic compensated patient before BMD evaluation [19]. Skeletal radiographs are less sensitive indicators of osteoporosis and osteopenia but are useful for detecting vertebral body fractures [16]. Other proposed evaluation methods include quantitative ultrasound and computed tomography, which exposes the patient to radiation.
Human immunodeficiency virus and osteoporosis
2020, Marcus and Feldman’s OsteoporosisEvaluation of handgrip strength as a predictor of sarcopenia in patients with HCV-related cirrhosis
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