Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Management of Osteoporosis in Liver Transplant Recipients

간이식 후 골다공증 관리

  • Choi, Hojeong (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Kim, Boram (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Kim, Yoonhee (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Jungwha (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Eunsook (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Euni (College of Pharmacy & Research Institute of Pharmaceutical Science, Seoul National University) ;
  • Cho, Jai Young (Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Choi, YoungRok (Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital)
  • 최호정 (분당서울대학교병원 약제부) ;
  • 김보람 (분당서울대학교병원 약제부) ;
  • 김윤희 (분당서울대학교병원 약제부) ;
  • 이정화 (분당서울대학교병원 약제부) ;
  • 이은숙 (분당서울대학교병원 약제부) ;
  • 김은경 (서울대학교 약학대학) ;
  • 조재영 (분당서울대학교병원 외과) ;
  • 최영록 (서울대학교병원 외과)
  • Received : 2019.10.11
  • Accepted : 2020.03.12
  • Published : 2020.03.31
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Abstract

Background: Prevention of osteoporosis and bone fracture is one of the important issues for liver transplant recipients because a long history of liver disease and lifelong use of immunosuppressants, including corticosteroids, may cause these diseases. In this study, we aimed to analyze liver recipient bone status, 10-year fracture risk, and medication history. Methods: The electronic medical records of adult patients aged >40 years who received liver transplantation at Seoul National University Bundang Hospital between January 2009 and June 2017 were reviewed retrospectively. On the basis of their bone mineral density and fracture history, their fracture risks were analyzed using the Korean fracture risk assessment tool. Results: A total of 57 liver transplant recipients were treated with corticosteroids during a mean of 8.8 months after transplantation. 30 patients (52.6%) showed bone metabolism dysfunction such as osteopenia or osteoporosis. The 10-year femoral fracture risk was 2.1%, and dual-energy X-ray absorptiometry monitoring was performed, including right before liver transplantation every 27.5±19.2 months. The mean femoral bone mineral density decreased by -7.2%±7.3%. Four patients (7.0%) had a fracture after liver transplantation. Osteoporotic fracture occurred in 3 patients with osteoporosis (25.0%). Among the osteopenia patients with moderate fracture risk who were not treated with bisphosphonate, 1 patient (12.5%) had a history of bone fracture after liver transplantation. Conclusions: Considering the deterioration of bone density and moderate fracture risk, medication for osteoporosis should be prescribed to liver transplant recipients with regular monitoring of bone density after transplantation.

Keywords

References

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