Osteoporosis Clinical Trial
Official title:
Skeletal Effects of Liver Transplantation
Fifty patients awaiting liver transplantation and 50 age and gender matched control subjects with normal liver function will be included in the study. The aim of this project is to compare liver transplantation recipients'bone microarchitecture with healthy controls and to evaluate patients' changes within one year after transplantation
Background: Solid organ transplantation recipients have a high prevalence of osteoporosis and
fragility fractures. Deteriorated bone architecture has been shown by high resolution
computed tomography (HR-pQCT) in kidney and lung transplantation recipients. In liver
transplantation (LeTx) recipients, bone microarchitecture has only been evaluated using the
trabecular bone score in a retrospective cohort study; a degraded or partially degraded
microarchitecture was detected in most of the patients.
Aim: The aim of this project is to compare LeTx recipients' bone microarchitecture with
healthy controls and to evaluate patients' changes within one year after transplantation.
Methods: HR-pQCT scans of the distal radius and tibia as well as areal bone mineral density
measurement of the lumbar spine and hip region will be performed before Tx, 1 and 12 months
after Tx in 50 patients. Anabolic and catabolic markers of bone turnover (sclerostin,
dickkopf 1, periostin) and traditional bone turnover markers will be evaluated
preoperatively, on the day of surgery, and 4 times within the first year after LeTx. In
healthy age- and sex-matched controls HR-pQCT, bone mineral density and laboratory parameters
will be assessed once.
Hypotheses: Based on the HR-pQCT data of kidney and lung transplantation recipients and the
trabecular bone score of LeTx recipients, the investigators hypothesize that LeTX recipients
have deteriorated bone microarchitecture.
Expected outcome: Since bone fragility is not only determined by BMD but bone architecture as
well, HR-pQCT data give important information on the patients' bone fragility. The knowledge
of the course of bone microarchitecture after liver transplantation may help to develop
strategies preventing fragility fractures in LeTx recipients.
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