Bone Mineral Density After Simultaneous Kidney–Pancreas Transplantation: Four Years Follow-up of 57 Recipients

• Published in: Transplantation proceedings Vol. 42; no. 2; pp. 555 - 557
• Main Authors: Pereira, S., Pedroso, S., Martins, L., Santos, P., Almeida, M., Freitas, C., Dias, L., Dores, J., Almeida, R., Castro Henriques, A., Teixeira, M.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.03.2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Blood Glucose - analysis; Bone Density - physiology; Cohort Studies; Creatinine - blood; Female; Femur Neck - pathology; Follow-Up Studies; Fractures, Bone - epidemiology; Fractures, Bone - etiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Glycated Hemoglobin A - analysis; Humans; Immunosuppressive Agents - therapeutic use; Investigative techniques, diagnostic techniques (general aspects); Kidney Transplantation - adverse effects; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Lumbar Vertebrae; Male; Medical sciences; Osteoarticular system. Muscles; Osteoporosis - epidemiology; Pancreas Transplantation - adverse effects; Pancreas Transplantation - immunology; Pancreas Transplantation - physiology; Patient Selection; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Spine - pathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue, organ and graft immunology; Young Adult; Human; Concurrent; Recipient; Homotransplantation; Kidney; Medicine; Treatment; Urinary system; Surveillance; Follow up study; Surgery; Graft; Bone mineral density; Pancreas; Kidney transplantation
• ISSN: 0041-1345; 1873-2623; 1873-2623
• DOI: 10.1016/j.transproceed.2010.01.046

Bone disease and an high risk of fractures are major problems in transplantation. Among diabetic patients undergoing simultaneous kidney–pancreas (SKP) transplantation, there are few studies assessing long-term effects on bone mass. The aim of this study was to evaluate bone mineral density (BMD) over 4 years follow-up after SKP transplantation. Fifty-seven patients had 22.8 ± 5.3 years of prior diabetes, 65% were female, and the overall mean age was 24.3 ± 5.93 years. At the time of transplantation, the lumbar spine and femoral neck T-scores were −1.75 ± 1.05 and −1.95 ± 0.73, respectively; 28% of subjects had evidence of osteoporosis. One year after transplantation, 77.6% of patients displayed improved lumbar T-scores to −1.33 ± 0.94 ( P = .044) with stable femoral neck T-scores. Bone densitometry enhanced gradually through the 4 years follow-up: lumbar T-score to −1.04 ± 0.67 ( P = .004) and femoral neck T-score to −1.69 ± 0.49 ( P = .12). At year 4, no osteoporosis cases were detected but 86.7% of patients did not receive steroids in the immunosuppressive regimen. The graft function remained stable (serum creatinine, 1.2 mg/dL; fasting glucose, 87.7 mg/dL). During the follow-up, BMD improved more significantly at cortical sites. Our study reports a reduced prevalence of fractures (8.7%) compared with the literature, which could be related to a steroid-sparing protocol and/or aggressively treatment of osteoporosis.