Kulak Carolina A Moreira, Borba Victória Z Cochenski, Kulak Júnior Jaime, Campos Denise Jonhsson, Shane Elizabeth
Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brasil.
Arq Bras Endocrinol Metabol. 2010 Mar;54(2):143-9. doi: 10.1590/s0004-27302010000200009.
Transplantation is an established therapy for many hematologic disorders as well as for end-stage diseases of the kidney, lung, liver, heart among others. Osteoporosis and a high incidence of fragility fractures have emerged as a complication of organ transplantation. Many factors contribute to the pathogenesis of osteoporosis following organ transplantation. In addition, most patients have some form of bone disease prior to transplantation, which is usually related to adverse effects of end-stage organ failure on the skeleton. This chapter reviews the mechanisms of bone loss that occur both in the early and late post-transplant periods including the contribution of immunosuppressive agents as well as the specific features of bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and treatment for osteoporosis in the transplant recipient will also be addressed.
移植是治疗多种血液系统疾病以及肾脏、肺、肝脏、心脏等终末期疾病的既定疗法。骨质疏松症和脆性骨折的高发病率已成为器官移植的一种并发症。许多因素促成了器官移植后骨质疏松症的发病机制。此外，大多数患者在移植前就患有某种形式的骨病，这通常与终末期器官衰竭对骨骼的不良影响有关。本章回顾了移植后早期和晚期发生骨质流失的机制，包括免疫抑制剂的作用以及肾、肺、肝、心脏和骨髓移植后骨质流失的具体特征。还将探讨移植受者骨质疏松症的预防和治疗。
