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Background <p>Post-transplantation bone disease has been established as a common consequence of solid organ transplant. This study aims to assess the incidence and risk factors of&#xa0;vertebral compression fractures following liver transplant surgery in a tertiary transplant&#xa0;care center.</p> Methods <p>Retrospective electronic audit included all patients undergoing liver transplant surgery&#xa0;at a tertiary transplant center, from 2016 to 2020, with at least 3 years of follow-up.&#xa0;Pre- and Post-transplant Data were collected. The Kaplan–Meier statistic was used to&#xa0;estimate the cumulative incidence of fractures. Statistical significance was determined&#xa0;by two-tailed P-values &lt; 0.05.</p> Results <p>434 patients were included in the audit, with a mean follow-up of 46.5 months.&#xa0;Vertebral fracture incidence was 8.3%, with most being at the thoracolumbar junction.&#xa0;The first year post-transplant recorded the highest fracture incidence rate with a mean&#xa0;of 10.5 months. The majority of patients were either osteoporotic or osteopenic pre and&#xa0;post-transplant. The utilization of bone protective medications was low pre- and posttransplant,&#xa0;at 11% and 18%, respectively. The mean duration of glucocorticoid use was&#xa0;26 months. Post-transplant use and duration of prednisoloneand other&#xa0;immunosuppressant medications showed no significant association with fracture&#xa0;incidence. Pre-transplant osteoporosis was predictive for vertebral fracture posttransplant&#xa0;(p = 0.011).</p> Conclusion <p>Our audit reveals a higher incidence of vertebral compression fractures following liver&#xa0;transplant compared to recently published data. The risk seems to be highest soon&#xa0;after the transplant. Post-transplantation bone disease prevention should focus on&#xa0;optimizing bone mass prior to transplantation and preventing bone loss in the early&#xa0;postoperative period.</p>

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Vertebral fracture incidence and risk factors following liver transplantation: tertiary transplant center experience

  • 期刊论文

  • 发表日期：

    2025年9月23日

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  • Khaled Almusrea,
  • Faisal Konbaz,
  • Fawaz N. Alshaalan,
  • Hamad S. Alhassan,
  • Nour Odeh,
  • Mayar Alatout,
  • Mohammed Althagafi,
  • Mosaab Alotaibi,
  • Ziyad Alyousef,
  • Anouar Bourghli

摘要

Background

Post-transplantation bone disease has been established as a common consequence of solid organ transplant. This study aims to assess the incidence and risk factors of vertebral compression fractures following liver transplant surgery in a tertiary transplant care center.

Methods

Retrospective electronic audit included all patients undergoing liver transplant surgery at a tertiary transplant center, from 2016 to 2020, with at least 3 years of follow-up. Pre- and Post-transplant Data were collected. The Kaplan–Meier statistic was used to estimate the cumulative incidence of fractures. Statistical significance was determined by two-tailed P-values < 0.05.

Results

434 patients were included in the audit, with a mean follow-up of 46.5 months. Vertebral fracture incidence was 8.3%, with most being at the thoracolumbar junction. The first year post-transplant recorded the highest fracture incidence rate with a mean of 10.5 months. The majority of patients were either osteoporotic or osteopenic pre and post-transplant. The utilization of bone protective medications was low pre- and posttransplant, at 11% and 18%, respectively. The mean duration of glucocorticoid use was 26 months. Post-transplant use and duration of prednisoloneand other immunosuppressant medications showed no significant association with fracture incidence. Pre-transplant osteoporosis was predictive for vertebral fracture posttransplant (p = 0.011).

Conclusion

Our audit reveals a higher incidence of vertebral compression fractures following liver transplant compared to recently published data. The risk seems to be highest soon after the transplant. Post-transplantation bone disease prevention should focus on optimizing bone mass prior to transplantation and preventing bone loss in the early postoperative period.