Intravenous bisphosphonate prevents symptomatic osteoporotic vertebral collapse in patients after liver transplantation

摘要: Osteoporosis is common in patients with chronic cholestatic liver disease, and atraumatic spinal fracture a recognized complication after orthotopic transplantation. Bisphosphonates are potent inhibitors of osteoclast bone resorption have been successfully used to treat postmenopausal osteoporosis. We examined whether preoperative mineral density can predict the risk transplantation intravenous bisphosphonate prevent fractures high-risk patients. Beginning February 1993, standard measurements lumbar spine were performed as part routine pretransplantation assessment. On basis preliminary analysis from January 1995, <0.84 g/cm2, or <84% predicted value (age/sex), treated (pamidronate disodium) every 3 months before for 9 Bone available 90 136 consecutive first transplants our unit 1993 September 1996. Before use pamidronate, 7 sustained symptomatic vertebral fractures. Their mean was lower than 38 no clinical evidence (81.8% +/- 12.3% v 94.2% 10.2%; P = .006). Since introduction occurred. Of 29 surviving g/cm2 transplantation, 38% who did not receive treatment pamidronate suffered spontaneous fracture, whereas 0 13 received such complication. A low associated high These results suggest that this considerably reduced by administration