Reuters Health Information (2005-08-12): Alendronate prevents bone loss after liver transplantation
Alendronate prevents bone loss after liver transplantation
Last Updated: 2005-08-12 15:50:13 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Alendronate in combination
with calcium and vitamin D prevents the bone loss that commonly follows
liver transplantation, according to a report in the August issue of
Osteoporosis commonly complicates advanced-stage liver disease and
persists or worsens after liver transplantation, lead author Dr. Gunda
Millonig and colleagues from Innsbruck Medical University, Innsbruck,
They therefore investigated the effects of treatment with
alendronate, calcium, and vitamin D in 136 patients who underwent liver
Most patients had decreased bone mineral density (BMD) prior to
transplantation, the authors report; 23.5% had osteoporosis and 48.5%
Patients with osteoporosis showed significant gains in lumbar and
femoral BMD within the months after liver transplantation, the report
indicates, whereas patients with osteopenia had stable lumbar BMD and
late increases in femoral BMD after liver transplantation.
Patients with normal BMD at baseline did not receive alendronate
after liver transplantation, the researchers note. These patients
experienced nonsignificant losses in femoral neck BMD, but not in
lumbar BMD, within the first months after liver transplantation.
The risk of fracture after liver transplantation was 5.8%, the
results indicate, with all fractures occurring within the first year
after the transplant.
Only two patients required discontinuation of alendronate because of side effects, the investigators report.
"The striking result of this study was that alendronate combined
with calcium and vitamin D almost completely prevented further bone
loss in the first 4 months after liver transplantation," the authors
conclude. "This is a significant improvement compared to the natural
course of bone loss within the first few months after liver
transplantation as reported in numerous publications."
"However," the researchers caution, "these results can only be
interpreted as hypothesis-generating for the present time, and further
randomized studies are needed."
Liver Transpl 2005;11:960-966.