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Assessment of serial changes of bone mineral density at lumbar spine and femoral neck before and after liver transplantation.

OBJECTIVE
To assess serial changes of bone mass before and after orthotopic liver transplantation (OLT).


METHODS
Consecutive bone mineral density (BMD) of lumbar spine (L2-L4) and femoral neck in 38 patients with chronic liver failure within 2 months before OLT, 6, 12 and 24 months after OLT was determined using dual energy X-ray absorptiometry.


RESULTS
29% of 38 patients before OLT had osteoporosis (BMD below 2 standard deviate). BMD levels at L2-L4 and femoral neck decreased and incidence of osteoporosis increased in the first 6 months after OLT. Over beyond 6 months post-OLT BMD levels at L2-L4 increased to just slightly above the pretransplant level and incidence of osteoporosis decreased from 36.8% (6 months after OLT) to 7.9% (24 months after OLT). Although BMD levels at femoral neck by 12 and 24 months after OLT gradually increased, BMD levels at femoral neck were still lower than those before OLT.


CONCLUSIONS
There was already a low bone mass in patients with chronic liver disease before OLT and liver transplantation induced a marked and rapid bone loss.