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  4. Bone mineral density in lung-transplant recipients before and after graft: prevention of lumbar spine post-transplantation-accelerated bone loss by pamidronate.
 
  • Détails
Titre

Bone mineral density in lung-transplant recipients before and after graft: prevention of lumbar spine post-transplantation-accelerated bone loss by pamidronate.

Type
article
Institution
Externe
Périodique
Journal of Heart and Lung Transplantation  
Auteur(s)
Trombetti, A.
Auteure/Auteur
Gerbase, M.W.
Auteure/Auteur
Spiliopoulos, A.
Auteure/Auteur
Slosman, D.O.
Auteure/Auteur
Nicod, L.P.
Auteure/Auteur
Rizzoli, R.
Auteure/Auteur
Liens vers les personnes
Nicod, Laurent  
ISSN
1053-2498[print], 1053-2498[linking]
Statut éditorial
Publié
Date de publication
2000
Volume
19
Numéro
8
Première page
736
Dernière page/numéro d’article
743
Langue
anglais
Résumé
BACKGROUND: Lung-transplant recipients are at risk of osteoporosis. They may have low bone mass even before posttransplantation immunosuppressive therapy. We studied bone mineral density (BMD) before and after lung transplantation and compared the efficacy of antiresorptive therapies to calcium and vitamin D supplementation. METHODS: Areal BMD was assessed in 42 patients awaiting lung transplantation and measured again after surgery at 6 (n = 29), and at 12 months (n = 20). Nineteen patients received antiresorptive therapy (30 mg pamidronate IV every 3 months (n = 14), or hormonal replacement therapy (n = 5)), and 10 patients received only calcium and vitamin D supplements.RESULTS: Mean age- and gender-adjusted lumbar spine (LS) and femoral neck (FN) BMD was significantly decreased prior to transplantation (- 0.6 +/- 0.2, p< 0.01, and - 1.5 +/- 0.2 standard deviation, p < 0.001, respectively). At that time, 29% were osteoporotic (T-score < - 2.5 below the peak bone mass), while 55% were below - 1.0 T-score. Antiresorptive therapy decreased the rate of LS bone loss during the first 6 months and led to a significant increase of BMD at 1 year, with LS changes of + 0.2 +/- 0.1 vs - 0.4 +/- 0.1 Z-score in the calcium-vitamin D group (p< 0.002), and + 0.2 +/- 0.1 vs - 0.04 +/- 0.1 for FN (NS). One out of 20 patients experienced clinically evident fractures during antiresorptive therapy, and 3 out of 12 in the calcium-vitamin D group. CONCLUSION: A significant proportion of patients awaiting lung transplantation was osteoporotic or osteopenic. Antiresorptive therapy (pamidronate or hormone-replacement therapy (HRT)) prevented accelerated LS bone loss after graft.
Sujets

Adolescent

Adult

Anti-Inflammatory Age...

Bone Density/drug eff...

Bone Resorption/preve...

Calcium/administratio...

Dietary Supplements

Diphosphonates/therap...

Female

Hormone Replacement T...

Humans

Lung Transplantation/...

Male

Middle Aged

Osteoporosis/preventi...

Postoperative Complic...

Spinal Diseases/preve...

Vitamin D/therapeutic...

PID Serval
serval:BIB_AB480C3B6195
DOI
10.1016/S1053-2498(00)00132-7
PMID
10967266
WOS
000089041400003
Permalien
https://iris.unil.ch/handle/iris/190892
Date de création
2010-02-19T17:57:22.097Z
Date de création dans IRIS
2025-05-21T01:50:29Z
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