Other Diseases

Why is my risk for osteoporosis higher after an organ transplant?

Many people who have had an organ transplant may already have several risk factors for osteoporosis (such as postmenopausal status, advanced age, Caucasian or Asian race, vitamin D deficiency, limited physical activity, consumption of excess alcohol and/or tobacco use.) In addition, many transplant patients have been exposed to medications that may lead to bone loss before surgery. Some examples include steroids (medications such as prednisone or cortisone taken for more than 3 months), certain diuretics, and blood-thinning medications (heparin or coumadin). An additional risk factor for people who have liver or kidney transplants is that end-stage organ failure may cause an inability to use calcium and vitamin D. This may cause bone loss before surgery. However, a major factor that leads to bone loss is the immunosuppressive therapy, steroids, and potentially some of the other medications required after surgery in order to have a successful organ transplant.

What are my risks for bone loss and fractures after transplant?

There is usually a rapid and substantial loss of bone in the first 6 to 12 months after a transplant and this loss may continue for several years. The rates of fracture after organ transplantation can be as high as 50% (1 out of every 2 individuals) depending on the organ transplanted and the type of fracture (spine, rib or other).

How can I prevent bone loss and fractures after transplant?

It is recommended that you speak with your doctor about getting a bone mineral density (BMD) test before your transplant operation. It is important to estimate your calcium intake and speak to your doctor to make sure that you are getting the right amount of calcium for you. It is also important to get enough vitamin D. Your doctor may want to check the vitamin D levels in your blood.

It would be beneficial for you to speak to your doctor about a referral to a physical therapist or about participation in a physical rehabilitation program. A physical therapist will take your medical condition and any physical limitations into consideration when planning a safe exercise program for healthy bones and overall health.

In order to minimize any bone loss after transplant, speak to your doctor about trying to prescribe the lowest steroid dose possible that is needed to treat your medical condition. Do not alter or stop taking any medications without your doctor's advice. If your bone mass is very low or if you have osteoporosis, your doctor may recommend that you take an osteoporosis medication to prevent bone loss and fractures. For more information go to: http://www.nlm.nih.gov/medlineplus/organtransplantation.html