eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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3/2021
vol. 7
 
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abstract:
Original paper

Prevalence and predictors of post-liver transplantation metabolic bone diseases

Maha Elsabaawy
1
,
Sameh Afify
1
,
Gasser El-Azab
1
,
Asmaa Gomaa
1
,
Nabil Omar
1
,
Mohamed Hashim
1
,
Dalia Elsabaawy
2
,
Helmy Elshazly
1

  1. Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen Elkoom, Egypt
  2. Department of Clinical Pharmacy, National Liver Institute, Menoufia University, Shebeen Elkoom, Egypt
Clin Exp HEPATOL 2021; 7, 3: 286-292
DOI: https://doi.org/10.5114/ceh.2021.109412
Online publish date: 2021/10/11
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Introduction
Post-liver transplantation (LTx) bone diseases have been poorly investigated. The frequency of bone diseases (osteopenia and osteoporosis) after LTx is unknown.
Aim of the study: To define prevalence and risk factors of bone disorders following LTx.

Material and methods
This prospective study was conducted on 100 consecutive adult patients who underwent living donor liver transplantation (LDLT) at the National Liver Institute (NLI) and survived longer than a year. Bone mineral density (BMD) was evaluated by dual-energy X-ray absorption (DEXA), as well as other pre- and postoperative risk factors.

Results
The frequencies of osteopenia and osteoporosis were found to be 14% and 8% among post-LTx patients. Seven recipients of the osteoporotic group were males, with mean age, and body mass index (BMI) before and after LTx 49.5 ±7.4 years, 24.1 ±4.7 kg/m2 and 22.8 ±1.5 kg/m2, respectively. A significant association between hepatitis C virus (HCV)-related cirrhosis, liver disease severity according to Child-Turcotte-Pugh (CTP) score, and alcoholism with decreased post-LTx BMD was substantiated (p < 0.05, 0.006). Post-LTx development of diabetes mellitus (DM), weight gain, use of corticosteroids and basiliximab all significantly affected decreased post-LTx BMD (p < 0.05). However, binary regression revealed that post-LTx occurrence of DM (p = 0.012, odds ratio [OR] = 0.099), the severity of liver disease (p = 0.023, OR = 0.217), and HCV (p = 0.011, OR = 0.173) are the main independent predictors of metabolic bone disease (MBD) occurrence one year after LTx.

Conclusions
Post-LTx bone disorders are not infrequent complications and should be more considered in those with HCV-related severe liver disease or developed DM after LTx.

keywords:

post-liver transplantation, bone disease, osteoporosis, osteopenia
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