Advanced

Pediatric solid organ transplantation and osteoporosis: a descriptive study on bone histomorphometric findings

Tamminen, Inari S.; Valta, Helena; Jalanko, Hannu; Salminen, Sari; Mayranpaa, Mervi K.; Isaksson, Hanna LU ; Kroger, Heikki and Makitie, Outi (2014) In Pediatric Nephrology 29(8). p.1431-1440
Abstract
Organ transplantation may lead to secondary osteoporosis in children. This study characterized bone histomorphometric findings in pediatric solid organ transplant recipients who were assessed for suspected secondary osteoporosis. Iliac crest biopsies were obtained from 19 children (7.6-18.8 years, 11 male) who had undergone kidney (n = 6), liver (n = 9), or heart (n = 4) transplantation a median 4.6 years (range 0.6-16.3 years) earlier. All patients had received oral glucocorticoids at the time of the biopsy. Of the 19 patients, 21 % had sustained peripheral fractures and 58 % vertebral compression fractures. Nine children (47 %) had a lumbar spine BMD Z-score below -2.0. Histomorphometric analyses showed low trabecular bone volume (<... (More)
Organ transplantation may lead to secondary osteoporosis in children. This study characterized bone histomorphometric findings in pediatric solid organ transplant recipients who were assessed for suspected secondary osteoporosis. Iliac crest biopsies were obtained from 19 children (7.6-18.8 years, 11 male) who had undergone kidney (n = 6), liver (n = 9), or heart (n = 4) transplantation a median 4.6 years (range 0.6-16.3 years) earlier. All patients had received oral glucocorticoids at the time of the biopsy. Of the 19 patients, 21 % had sustained peripheral fractures and 58 % vertebral compression fractures. Nine children (47 %) had a lumbar spine BMD Z-score below -2.0. Histomorphometric analyses showed low trabecular bone volume (< -1.0 SD) in 6 children (32 %) and decreased trabecular thickness in 14 children (74 %). Seven children (37 %) had high bone turnover at biopsy, and low turnover was found in 6 children (32 %), 1 of whom had adynamic bone disease. There was a great heterogeneity in the histological findings in different transplant groups, and the results were unpredictable using non-invasive methods. The observed changes in bone quality (i.e. abnormal turnover rate, thin trabeculae) rather than the actual loss of trabecular bone, might explain the increased fracture risk in pediatric solid organ transplant recipients. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone histomorphometry, Cancellous bone, Organ transplantation, Fracture, Glucocorticoid treatment, Children
in
Pediatric Nephrology
volume
29
issue
8
pages
1431 - 1440
publisher
Springer
external identifiers
  • wos:000338700400019
  • scopus:84903772433
ISSN
1432-198X
DOI
10.1007/s00467-014-2771-1
language
English
LU publication?
yes
id
f7ac688d-1642-4620-a748-574ece471b33 (old id 4598932)
date added to LUP
2014-09-05 09:20:33
date last changed
2017-10-29 04:01:36
@article{f7ac688d-1642-4620-a748-574ece471b33,
  abstract     = {Organ transplantation may lead to secondary osteoporosis in children. This study characterized bone histomorphometric findings in pediatric solid organ transplant recipients who were assessed for suspected secondary osteoporosis. Iliac crest biopsies were obtained from 19 children (7.6-18.8 years, 11 male) who had undergone kidney (n = 6), liver (n = 9), or heart (n = 4) transplantation a median 4.6 years (range 0.6-16.3 years) earlier. All patients had received oral glucocorticoids at the time of the biopsy. Of the 19 patients, 21 % had sustained peripheral fractures and 58 % vertebral compression fractures. Nine children (47 %) had a lumbar spine BMD Z-score below -2.0. Histomorphometric analyses showed low trabecular bone volume (&lt; -1.0 SD) in 6 children (32 %) and decreased trabecular thickness in 14 children (74 %). Seven children (37 %) had high bone turnover at biopsy, and low turnover was found in 6 children (32 %), 1 of whom had adynamic bone disease. There was a great heterogeneity in the histological findings in different transplant groups, and the results were unpredictable using non-invasive methods. The observed changes in bone quality (i.e. abnormal turnover rate, thin trabeculae) rather than the actual loss of trabecular bone, might explain the increased fracture risk in pediatric solid organ transplant recipients.},
  author       = {Tamminen, Inari S. and Valta, Helena and Jalanko, Hannu and Salminen, Sari and Mayranpaa, Mervi K. and Isaksson, Hanna and Kroger, Heikki and Makitie, Outi},
  issn         = {1432-198X},
  keyword      = {Bone histomorphometry,Cancellous bone,Organ transplantation,Fracture,Glucocorticoid treatment,Children},
  language     = {eng},
  number       = {8},
  pages        = {1431--1440},
  publisher    = {Springer},
  series       = {Pediatric Nephrology},
  title        = {Pediatric solid organ transplantation and osteoporosis: a descriptive study on bone histomorphometric findings},
  url          = {http://dx.doi.org/10.1007/s00467-014-2771-1},
  volume       = {29},
  year         = {2014},
}