Pharmacologic management of metastatic bone disease.

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Abstract

[Indexed for MEDLINE] 12. Transplant Proc. 2021 Sep;53(7):2346-2353. doi: 10.1016/j.transproceed.2021.07.049. Epub 2021 Aug 20. Bone Disease and Liver Transplantation: A Review. Rodríguez-Aguilar EF(1), Pérez-Escobar J(2), Sánchez Herrera D(3), García-Alanis M(4), Toapanta-Yanchapaxi L(5), Gonzalez-Flores E(6), García-Juárez I(7). Author information: (1)Liver Transplant Unit, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), University of Barcelona; Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas (Ciberhed), Barcelona, Spain. (2)Gastroenterology and Hepatology, Punto Clínico Especialistas, México City, Mexico. (3)Facultad Mexicana de Medicina, Universidad La Salle, Hospital Ángeles Pedregal, México City, Mexico. (4)Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico. (5)Clínica de Enfermedades Neuromusculares, Departamento de Neurología y Psiquiatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico. (6)Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), México City, Mexico. (7)Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, Mexico. Electronic address: drinter77@gmail.com. Liver transplantation is currently the most effective and almost routine treatment for chronic and acute liver diseases. The survival of transplanted patients has increased exponentially, which has led to more knowledge of the long-term complications secondary to the underlying pathology or the various treatments that must be followed. Bone metabolic disease is a chronic complication of liver transplantation that inhibits quality of life. The factors that contribute to the development of bone disease are different according to the various etiologies of liver damage. All patients should be examined for osteoporosis risk factors because the incidence of new fractures in transplant patients is higher during the first year after transplantation, reflecting the greater bone loss during this time. This article outlines a proposal for a treatment algorithm; we propose that pharmacologic therapy in patients post liver transplant should first consider the diagnosis of osteoporosis by bone mineral density, the patient's personal and family history of spine and femoral neck fractures, and the use glucocorticoids (dose and time) until a tool is available that allows the best estimation of the fracture risk in this population of patients. Copyright © 2021 Elsevier Inc. All rights reserved. DOI: 10.1016/j.transproceed.2021.07.049