Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation
Peter W Schreiber, Heike A Bischoff-Ferrari, Katia Boggian, Marco Bonani, Christian Van Delden, Natalia Enriquez, Thomas Fehr, Christian Garzoni, Hans H Hirsch, Cédric Hirzel, Oriol Manuel, Pascal Meylan, Lanja Saleh, Maja Weisser, Nicolas J Mueller & Swiss Transplant Cohort Study (STCS)
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Kurzfassung
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Bone disease contributes to relevant morbidity after solid organ
transplantation. Vitamin D has a crucial role for bone metabolism.
Activation of vitamin D depends on the endocrine function of both,
liver and kidney. Our study assessed key markers of bone metabolism
at time of transplantation and 6 months after transplantation among
70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH
vitamin D levels did not differ significantly between
peri-transplant (median 32.5nmol/l) and 6 months post-transplant
(median 41.9nmol/l; P = 0.272). Six months post-transplant median 1,
25-(OH)2 vitamin D levels increased by >300% (from 9.1 to
36.5ng/l; P<0.001) and median intact parathyroid hormone levels
decreased by 68.4% (from 208.7 to 66.0 ng/l; P<0.001). Median
β-Crosslaps (CTx) and total procollagen type 1 amino-terminal
propeptide (P1NP) decreased by 65.1% (from 1.32 to 0.46ng/ml;
P<0.001) and 60.6% (from 158.2 to 62.3ng/ml; P<0.001),
respectively. Kidney recipients with incident fractures had
significantly lower levels of 1, 25-(OH)2 vitamin D at time of
transplantation and of intact parathyroid hormone 6 months
post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1,
25-(OH)2 vitamin D and intact parathyroid hormone levels were not
significantly altered between peri-transplant and 6 months
post-transplant. Contrary to kidney recipients, median CTx increased
by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3%
(from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course.
Assessed biomarkers didn't differ between liver recipients with and
without fractures. To conclude, the assessed panel of biomarkers
proved highly dynamic after liver as well as kidney transplantation
in the early post-transplant period. After kidney transplantation a
significant gain in 1, 25-(OH)2 vitamin D combined with a decline in
iPTH, CTx and P1NP, whereas after liver transplantation an increase
in CTx and P1NP were characteristic.
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Zitation
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Schreiber P W, Bischoff-Ferrari H A, Boggian K, Bonani M, Van Delden
C, Enriquez N, Fehr T, Garzoni C, Hirsch H H, Hirzel C, Manuel O,
Meylan P, Saleh L, Weisser M, Mueller N J, Swiss Transplant Cohort
Study (STCS) . Bone metabolism dynamics in the early post-transplant
period following kidney and liver transplantation. PLoS ONE 2018;
13:e0191167.
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Typ
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Wissenschaftlicher Artikel/Review (Englisch)
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Veröffentlichungsdatum
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16-01-2018
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Titel der Zeitschrift
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PLoS ONE (13/1)
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ISSN electronic
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1932-6203
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Seiten
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e0191167
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PubMed
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29338022
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DOI
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10.1371/journal.pone.0191167
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