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

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Author

  • Inari S. Tamminen
  • Helena Valta
  • Hannu Jalanko
  • Sari Salminen
  • Mervi K. Mayranpaa
  • Hanna Isaksson
  • Heikki Kroger
  • Outi Makitie

Summary, in English

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.

Department/s

Publishing year

2014

Language

English

Pages

1431-1440

Publication/Series

Pediatric Nephrology

Volume

29

Issue

8

Document type

Journal article

Publisher

Springer

Topic

  • Orthopedics

Keywords

  • Bone histomorphometry
  • Cancellous bone
  • Organ transplantation
  • Fracture
  • Glucocorticoid treatment
  • Children

Status

Published

ISBN/ISSN/Other

  • ISSN: 1432-198X