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01.08.2014 | Original Article

Pediatric solid organ transplantation and osteoporosis: a descriptive study on bone histomorphometric findings

verfasst von: Inari S. Tamminen, Helena Valta, Hannu Jalanko, Sari Salminen, Mervi K. Mäyränpää, Hanna Isaksson, Heikki Kröger, Outi Mäkitie

Erschienen in: Pediatric Nephrology | Ausgabe 8/2014

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Abstract

Background

Organ transplantation may lead to secondary osteoporosis in children. This study characterized bone histomorphometric findings in pediatric solid organ transplant recipients who were assessed for suspected secondary osteoporosis.

Methods

Iliac crest biopsies were obtained from 19 children (7.6–18.8 years, 11 male) who had undergone kidney (n = 6), liver (n = 9), or heart (n = 4) transplantation a median 4.6 years (range 0.6–16.3 years) earlier. All patients had received oral glucocorticoids at the time of the biopsy.

Results

Of the 19 patients, 21 % had sustained peripheral fractures and 58 % vertebral compression fractures. Nine children (47 %) had a lumbar spine BMD Z-score below −2.0. Histomorphometric analyses showed low trabecular bone volume (< −1.0 SD) in 6 children (32 %) and decreased trabecular thickness in 14 children (74 %). Seven children (37 %) had high bone turnover at biopsy, and low turnover was found in 6 children (32 %), 1 of whom had adynamic bone disease.

Conclusions

There was a great heterogeneity in the histological findings in different transplant groups, and the results were unpredictable using non-invasive methods. The observed changes in bone quality (i.e. abnormal turnover rate, thin trabeculae) rather than the actual loss of trabecular bone, might explain the increased fracture risk in pediatric solid organ transplant recipients.

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Titel: Pediatric solid organ transplantation and osteoporosis: a descriptive study on bone histomorphometric findings
verfasst von: Inari S. Tamminen
Helena Valta
Hannu Jalanko
Sari Salminen
Mervi K. Mäyränpää
Hanna Isaksson
Heikki Kröger
Outi Mäkitie
Publikationsdatum: 01.08.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 8/2014
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-2771-1

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Pediatric solid organ transplantation and osteoporosis: a descriptive study on bone histomorphometric findings