Lan Gong-bin, Xie Xu-biao, Peng Long-kai, Liu Lei, Song Lei, Dai He-long
Center of Organ Transplantation, The Second Xiangya Hospital of Central South University, Changsha 410011, China.
Biomed Res Int. 2015;2015:413169. doi: 10.1155/2015/413169. Epub 2015 Nov 15.
Improved survival following organ transplantation has brought to the forefront some long-term complications, among which osteoporosis and associated fractures are the major ones that adversely affect the quality of life in recipients. The pathogenesis of osteoporosis in transplant recipients is complex and multifactorial which may be related to increased bone resorption, decreased bone formation, or both. Studies have shown that the preexisting underlying metabolic bone disorders and the use of immunosuppressive agents are the major risk factors for osteoporosis and fractures after organ transplantation. And rapid bone loss usually occurs in the first 6-12 months with a significant increase in fracture risk. This paper will provide an updated review on the possible pathogenesis of posttransplant osteoporosis and fractures, the natural history, and the current prevention and treatment strategies concerning different types of organ transplantation.
器官移植后生存率的提高使一些长期并发症成为关注焦点,其中骨质疏松症及相关骨折是严重影响受者生活质量的主要并发症。移植受者骨质疏松症的发病机制复杂且具有多因素性,可能与骨吸收增加、骨形成减少或两者均有关。研究表明,移植前存在的潜在代谢性骨病以及免疫抑制剂的使用是器官移植后发生骨质疏松症和骨折的主要危险因素。而且快速骨质流失通常发生在最初的6 - 12个月,骨折风险显著增加。本文将对移植后骨质疏松症和骨折的可能发病机制、自然病程以及当前针对不同类型器官移植的预防和治疗策略进行更新综述。