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approach to the Patient with Transplantation related bone loss

Transplantation is an established therapy for end-stage diseases of the kidney, endocrine pancreas, heart, liver, lung, intestines and for many hematological disorders. Current immunosuppressive regimens with glucocorticoids and calcineurin inhibitors produce excellent Patient and graft survival rates. This has resulted in both increases in transplant numbers and an increased recognition of previously neglected long-term complications of Transplantation such as fractures and osteoporosis. Both preTransplantation bone disease and immunosuppressive therapy result in rapid bone loss and increased fracture rates. Patients are particularly at risk early after Transplantation. The bone health of candidates for organ Transplantation should be assessed with bone densitometry of the hip and spine. Spinal x-rays should be performed to diagnose prevalent fractures. Any secondary causes of osteoporosis should be identified and treated. Vitamin D deficiency should be corrected with vitamin D doses selected to achieve ...