Department of Medicine, Addenbrooke's Hospital, Cambridgeshire CB2 0QQ, UK.
QJM. 2011 Jul;104(7):599-606. doi: 10.1093/qjmed/hcr025. Epub 2011 Mar 8.
High rates of fracture following liver transplantation were reported in earlier years, but the impact of subsequent changes in immune suppression and the introduction of bone-protective therapy on fracture rate have not been reported.
The aim of this study was to document clinical fracture incidence during the period 1998-2008 in a single transplant centre, following the introduction of a bone management protocol.
It was designed as a retrospective cohort.
Records were retrieved from 531 of 592 eligible patients in an audit of all patients undergoing a first liver transplant during the 10-year period. All fractures were verified radiologically.
The mean follow-up period was 61.4 months. Prior to transplantation 5.6% of patients had a history of fracture. Incident clinical fractures following transplantation were recorded in just 15 (3.5%) patients. The most common fracture site was the spine and the median time from transplant to fracture was 26 months (range 2-83 months).
There was a low fracture rate in patients undergoing liver transplantation in this centre over the past 10 years. This rate is lower than that in previous reports, which is likely to reflect the use of lower doses of prednisolone for immune suppression and the administration of bone-protective therapy to high-risk patients.
早年有报道称肝移植后骨折发生率较高，但随后免疫抑制的变化以及骨保护治疗的引入对骨折发生率的影响尚未报道。
本研究旨在记录单一移植中心在引入骨管理方案后，1998 年至 2008 年期间的临床骨折发生率。
这是一项回顾性队列研究。
对 10 年间所有首次接受肝移植的 592 名符合条件的患者中的 531 名患者进行了审计，从中检索了记录。所有骨折均经影像学证实。
平均随访时间为 61.4 个月。移植前，5.6%的患者有骨折病史。在 15 名（3.5%）患者中记录到移植后发生的临床骨折。最常见的骨折部位是脊柱，从移植到骨折的中位数时间为 26 个月（范围 2-83 个月）。
在过去的 10 年中，该中心接受肝移植的患者骨折发生率较低。这一比率低于以往的报告，这可能反映了免疫抑制治疗中使用较低剂量的泼尼松龙以及对高危患者进行骨保护治疗。
