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Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2022 Apr 22;43(1):101-107. Epub 2022 Apr 22.

Gazi University Faculty of Medicine, Department of Nephrology, Ankara, Turkey.

: Since glucocorticoids are used in low maintenance doses today, the relationship between calcineurin inhibitors (CNI) and osteoporosis has become clinically significant in osteoporosis after solid organ transplantation. However, there is evidence that the mammalian target of rapamycin inhibitors (mTORi) may be beneficial via osteoclast inhibition. : The bone mineral density (BMD) changes are investigated in renal transplant patients under CNI or mTORi-based maintenance regimens during the first five-year post-transplant course. Read More

Medicina (Kaunas) 2020 Jun 19;56(6). Epub 2020 Jun 19.

Department of Internal Medicine and Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, MS 39156, USA.

Bone and mineral disorders are common after organ transplantation. Osteoporosis post transplantation is associated with increased morbidity and mortality. Pathogenesis of bone disorders in this particular sub set of the population is complicated by multiple co-existing factors like preexisting bone disease, Vitamin D deficiency and parathyroid dysfunction. Read More

Int J Endocrinol 2020 4;2020:3410921. Epub 2020 May 4.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Purpose: Denosumab is a monoclonal antibody that prevents the development of osteoclasts. The effect of denosumab in solid organ transplant recipients has been elucidated, but its effect in haematopoietic stem cell transplantation recipients has not been studied yet. The aim of this study was to determine the effectiveness and safety of denosumab in haematopoietic stem cell transplantation recipients. Read More

J Cyst Fibros 2019 10;18 Suppl 2:S111-S119

Pediatrics, The Children's Hospital of Philadelphia, The Roberts Center for Pediatric Research, Room 14363, Philadelphia, PA 19104, USA. Electronic address:

In individuals with cystic fibrosis (CF), severe pulmonary or liver disease is frequently addressed with lung or liver transplant, respectively. Specific endocrine co-morbidities including diabetes mellitus, osteoporosis, and adrenal insufficiency accompany solid organ transplant and may be particularly problematic in individuals with CF, who are already at increased risk of diabetes and compromised bone health. Diabetes and osteoporosis screening and initiation of appropriate preventive measures are recommended prior to transplant. Read More

Bone 2019 10 9;127:401-418. Epub 2019 Jul 9.

Bone Center, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands. Electronic address:

Introduction: Solid organ transplantation is an established therapy for end-stage organ failure. Both pre-transplantation bone disease and immunosuppressive regimens result in rapid bone loss and increased fracture rates.

Methods: The European Calcified Tissue Society (ECTS) formed a working group to perform a systematic review of existing literature on the consequences of end-stage kidney, liver, heart, and lung disease on bone health. Read More

Gynecol Endocrinol 2019 Jun 2;35(6):470-472. Epub 2019 Jan 2.

a Gynecology and Physiopathology of Human Reproduction Unit, Department of Medical and Surgical Sciences , University of Bologna S. Orsola-Malpighi Hospital of Bologna , Bologna , Italy.

In this case report, we describe the outcomes of two heterotopic transplantations of cryopreserved ovarian tissue performed in a patient with HL, after 11 and 15 years of storage. At the age of 30, the patient underwent laparoscopy to collect ovarian tissue for cryopreservation before chemotherapy and radiotherapy. Eleven years later she experienced premature ovarian failure (POF). Read More

Expert Rev Respir Med 2018 11 21;12(11):893-904. Epub 2018 Sep 21.

a Department of Pediatrics, Nationwide Children's Hospital , The Ohio State University College of Medicine , Columbus , OH , USA.

Introduction: Survival after lung transplantation lags behind outcomes of other solid organ transplants, and complications from lung transplant are the second most common cause of death in cystic fibrosis. Evolving surgical techniques, therapeutics, and perioperative management have improved short-term survival after lung transplantation, yet have not translated into significant improvement in long-term mortality. Areas covered: We review risk factors for poor long-term outcomes among patients with cystic fibrosis undergoing lung transplantation to highlight areas for improvement. Read More

Front Med (Lausanne) 2018 31;5:211. Epub 2018 Jul 31.

Division of Nephrology and Solid-Organ Transplantation, Michael E. DeBakey VA Medical Center, Houston, TX, United States.

The risk of mineral and bone disorders among patients with chronic kidney disease is substantially elevated, owing largely to alterations in calcium, phosphorus, vitamin D, parathyroid hormone, and fibroblast growth factor 23. The interwoven relationship among these minerals and hormones results in maladaptive responses that are differentially affected by the process of kidney transplantation. Interpretation of conventional labs, imaging, and other fracture risk assessment tools are not standardized in the post-transplant setting. Read More

Front Endocrinol (Lausanne) 2018 17;9:162. Epub 2018 Apr 17.

Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia.

Objective: Osteoporosis and fragility fractures represent serious complications for the solid organ transplant population. The recommended osteoporosis therapy for organ recipients involves supplementation with calcium and vitamin D and bisphosphonate administration. However, these options can prove limited for patients with impaired renal function. Read More

Clin J Am Soc Nephrol 2018 04 11;13(4):652-654. Epub 2018 Jan 11.

Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia

Pharmacogenomics J 2017 12 18;17(6):481-487. Epub 2017 Apr 18.

Pediatric Nephrology and Rheumatology Department, Ghent University Hospital, Ghent, Belgium.

The use of calcineurin inhibitors (CNIs) and vitamin D deficiency may contribute to the pathogenesis of post-transplant bone disease. CNIs and 1,25-dihydroxyvitamin D₃ (1,25(OH)D) are substrates of the drug-metabolizing enzyme CYP3A4. This review summarizes the indications for the use of activated vitamin D analogs in post-transplant care and the current knowledge on the impact of CNIs on bone. Read More

J Bone Miner Res 2017 May 1;32(5):1116-1125. Epub 2017 Mar 1.

Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.

Chronic renal, liver, and heart failure in children associates with multiple skeletal complications. Increased fracture incidence often persists after transplantation and could be related to alterations in bone material properties. In the present cohort study we evaluated bone mineralization density distribution (BMDD) by quantitative backscattered electron imaging (qBEI) in 23 pediatric solid organ allograft recipients with suspected osteoporosis. Read More

FP Essent 2016 Nov;450:22-27

Department of Family Medicine Louisiana State University School of Medicine, 1542 Tulane Ave, New Orleans, LA 70112.

Nearly 31,000 US patients received solid organ transplants in 2015 and the number is increasing. Care of transplant recipients includes management of a variety of common posttransplantation issues. Skin cancers are common because of immunosuppression and require skin examinations at intervals. Read More

Respir Med 2016 08 7;117:103-8. Epub 2016 Jun 7.

Department of Cardiothoracic Transplantation, Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE7 7DN, United Kingdom; Institute of Cellular Medicine, Newcastle Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom. Electronic address:

Background: Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors.

Methods: We describe the demographics, clinical history and post-procedure function of all lung transplant recipients who have survived greater than 20 years at our centre. Read More

Biomed Res Int 2015 15;2015:413169. Epub 2015 Nov 15.

Center of Organ Transplantation, The Second Xiangya Hospital of Central South University, Changsha 410011, China.

Improved survival following organ transplantation has brought to the forefront some long-term complications, among which osteoporosis and associated fractures are the major ones that adversely affect the quality of life in recipients. The pathogenesis of osteoporosis in transplant recipients is complex and multifactorial which may be related to increased bone resorption, decreased bone formation, or both. Studies have shown that the preexisting underlying metabolic bone disorders and the use of immunosuppressive agents are the major risk factors for osteoporosis and fractures after organ transplantation. Read More

Osteoporos Int 2016 Apr 16;27(4):1425-1440. Epub 2015 Oct 16.

Department of Pharmacy Services, University of Michigan Hospitals and Health Centers, Victor Vaughan House, 1111 E. Catherine, Ann Arbor, MI, 48109, USA.

The prevention and treatment of osteoporosis is an increasingly important topic in the solid organ transplant (SOT) population. Compared to the general population, these patients are at an elevated risk of developing osteoporosis due to progressive disease, lifelong immunosuppressant therapy, and malnutrition. As patients live longer after transplant, chronic disease management is increasingly more important. Read More

Int J Endocrinol 2015 27;2015:280164. Epub 2015 Jul 27.

Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha 410011, China.

Osteoporosis (OP) has emerged as a frequent and devastating complication of organ solid transplantation process. Bone loss after organ transplant is related to adverse effects of immunosuppressants on bone remodeling and bone quality. Many factors contribute to the pathogenesis of OP in transplanted patients. Read More

Mayo Clin Proc 2014 Jul 5;89(7):888-95. Epub 2014 May 5.

Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address:

Objective: To investigate the incidence of bone disorders after solid organ transplantation (SOT).

Participants And Methods: We used Taiwan's National Health Insurance Research Database to identify 9428 recipients of SOT and 38,140 sex- and age- matched control subjects between January 1, 1997, and December 31, 2010, to compare the incidence and risk of bone disorders between groups.

Results: Recipients of SOT had a significantly higher incidence of osteoporosis and related fractures compared with the non-SOT group. Read More

Pediatr Nephrol 2014 Aug 23;29(8):1431-40. Epub 2014 Feb 23.

Bone and Cartilage Research Unit (BCRU), University of Eastern Finland, POB 1627, Mediteknia Building, 70211, Kuopio, Finland,

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. Read More

Endocr Pract 2013 Jan-Feb;19(1):120-8

Division of Endocrinology and Metabolism, Loyola University Medical Center, Maywood, IL 60153, USA.

Objective: To provide an updated review of several causes of secondary osteoporosis as well as screening recommendations for these disorders.

Methods: We conducted an updated review of the literature published since 2006 on secondary causes of osteoporosis. This information has been added to the relevant data published between 1990 and 2006, which was included in our prior review from 2006. Read More

Minerva Endocrinol 2012 Sep;37(3):221-31

Department of Internal Medicine, Federal University of Parana, Curitiba, Brazil.

Osteoporosis and high risk of fractures have emerged as frequent and devastating complications of organ solid transplantation process. Bone loss after organ transplant is related to adverse effects of immunosuppressive drugs on bone remodeling and bone quality. Many factors contribute to the pathogenesis of osteoporosis in transplanted patients. Read More

Clin Kidney J 2012 Feb 28;5(1):13-6. Epub 2012 Jan 28.

Division of Musculoskeletal Radiology, Department of Diagnostic Imaging, Alpert Medical School of Brown University, Providence, RI, USA.

Bone disease remains a major cause of morbidity after renal transplantation. Post-transplant osseous complications include osteoporosis and osteonecrosis, both historically associated with glucocorticoids, and a newer syndrome of bone pain associated with calcineurin inhibitors. Calcineurin inhibitor-induced pain syndrome (CIPS) is a reversible etiology of lower extremity bone pain and bone marrow edema reported in patients receiving cyclosporine or tacrolimus after solid organ or bone marrow transplantation. Read More

Ageing Res Rev 2012 Jan 1;11(1):181-7. Epub 2011 Jul 1.

Department of Surgery, Division of Transplantation, Medical University Graz, Austria.

Introduction: Many transplant studies in elderly patients focus on survival and mortality rates. It was the aim of this review to evaluate publications dealing with individual patient performance and independence.

Methods: The literature search included all articles retrievable for the hit "transplantation in elderly recipients" between 1960 and 2010. Read More

Transplantation 2011 Jul;92(1):106-11

Department of Medicine, Clinic of Internal Medicine, Section D, University of Verona, Verona, Italy.

Background: Bone disease is one of the major complications of solid organ transplantation, causes considerable morbidity, and most patients are treated with immunosuppressant drugs after graft. The majority of studies reported rapid bone loss and an increased incidence of fractures after transplantation. The aim of our study was to evaluate osteoporosis and fracture prevalence, bone metabolism, and the effect of immunosuppressant agents on bone after heart transplantation. Read More

Expert Rev Endocrinol Metab 2011 Mar;6(2):157-176

a UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8885, USA.

Organ transplantation has become popular for the management of various chronic illnesses. With the advent of modern immunosuppressive treatments, the longevity of transplant recipients has increased. Consequently, morbid complications such as osteoporosis and bone fractures are seen at an increasing frequency in this population. Read More

Osteoporos Int 2011 Jul 5;22(7):2107-18. Epub 2011 Jan 5.

Department of Medicine, Columbia University Medical Center, 630 West 168th Street, PH8-864, New York, NY 10032, USA.

Vitamin D deficiency is prevalent among patients with end-stage organ failure awaiting transplant. Low serum 25-hydroxyvitamin D (25-OHD) levels in these patients may be related to many disease-specific factors, as well as decreased sunlight exposure and limited intake of foods containing vitamin D. Low serum 25-OHD levels are also extremely common following solid organ transplantation, both during the immediate postoperative period and in long-term graft recipients. Read More

Transplantation 2010 Nov;90(9):1006-10

Division of Pediatric Endocrinology and Diabetology, University Children's Hospital, Munich, Germany.

Background: Impaired bone health has been advocated after solid organ transplantation in adult and pediatric patients. Osteoporosis accompanied by fractures have been found also in heart transplantation recipients.

Methods: Parameters of bone mineral density (BMD) and bone geometry were measured in 34 patients (15 females, mean age: 14. Read More

Expert Rev Respir Med 2009 Aug;3(4):403-23

Division of Pulmonary and Critical Care Medicine and the Cystic Fibrosis/Pulmonary Research and Treatment Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7524, USA.

Lung transplantation has become a proven therapeutic option for patients with end-stage lung disease, extending life and providing improved quality of life to those who otherwise would continue to be breathless and oxygen-dependent. Over the past 20 years, considerable experience has been gained in understanding the multitude of medical and surgical issues that impact upon patient survival. Today, clinicians have an armamentarium of tools to manage diverse problems such as primary graft dysfunction, acute and chronic allograft rejection, airway anastomotic issues, infectious complications, renal dysfunction, diabetes and osteoporosis, hematological and gastrointestinal problems, malignancy, and other unique issues that confront immunosuppressed solid organ transplant recipients. Read More

Clin Transplant 2010 Sep-Oct;24(5):E145-52

Section of Nephrology, Department of Medicine, Rikshospitalet, Oslo, Norway.

Post-transplant bone disease is common in solid organ recipients; however, there is limited information on their pre-transplant bone status. We aimed to compare bone mineral density (BMD) in different categories of patients with end-stage organ failure awaiting transplantation (Tx) in Norway. Overall 291 adult patients were enrolled, including 60, 84, 81 and 66 patients with end-stage lung, liver, kidney and heart failure, respectively. Read More