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Osteoporosi nel paziente sottoposto a trapianto d’organo
Pubblicato su:
La Rivista Italiana di Ostetricia e Ginecologia n. 5-6
Abstract Transplantation is actually the most reliable treatment for many patients with end-stage organ failure. Due to the progresses both in surgical techniques and immunosuppressive treatment, long-term patient survival has remarkably increased in the last years. In spite of this, a number of complications still can occur after transplant and, among them, post-transplantation bone disease is one of the most frequent.
Osteoporosis can be detected in up to 50-60% of transplant recipients, while fragility fractures, mostly of the vertebrae, may be present in 10- 40% of patients. Corticosteroids use is one of the most important pathogenetic factors. More contrasting data have been reported about the effects on bone metabolism of cyclosporin A and tacrolimus. The underlying organ disease is probably the most important factor affecting skeletal tissue, thus explaining the large differences existing in the clinical course of bone disease in this setting. No treatment protocol has been fully validated in preventing fractures in these patients. However, recent data indicate that several drugs are effective in preventing or treating post-transplantation bone loss.