Kumar Santhosh E, Cherian Kripa E, Paul Thomas V, Goel Ashish
Department of Hepatology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India.
J Clin Exp Hepatol. 2023 Nov-Dec;13(6):1130-1139. doi: 10.1016/j.jceh.2023.05.003. Epub 2023 May 12.
Liver transplant outcomes have improved over the years, and currently, the quality of life and long-term well-being of these patients needs to be improved. Improving bone health goes a long way toward achieving this objective. Poor bone health (osteopenia and osteoporosis) although prevalent, is often overlooked owing to its asymptomatic nature. It can be complicated by debilitating fracture affecting quality of life. It is recommended to assess and optimize bone health prior to liver transplant. Multiple factors contribute to poor bone health in a liver transplant recipient and it is vital to understand and ameliorate these. A careful and targeted approach with inputs from multidisciplinary team involving transplant physician, endocrinologist, occupational therapist, nutritionist, and nursing personnel may often be required. In this review, we aim to concisely discuss the various aspects related to prevalence, pathophysiology, evaluation, treatment, and follow-up of bone disease among liver transplant recipients.
多年来,肝移植的结果已有改善,而目前,这些患者的生活质量和长期健康状况仍有待提高。改善骨骼健康对实现这一目标大有帮助。骨骼健康不佳(骨质减少和骨质疏松)虽然普遍存在,但因其无症状的特性而常常被忽视。它可能会因导致生活质量下降的虚弱性骨折而变得复杂。建议在肝移植前评估并优化骨骼健康状况。多种因素导致肝移植受者骨骼健康不佳,了解并改善这些因素至关重要。通常可能需要来自多学科团队(包括移植内科医生、内分泌科医生、职业治疗师、营养师和护理人员)的谨慎且有针对性的方法。在本综述中,我们旨在简要讨论与肝移植受者骨病的患病率、病理生理学、评估、治疗及随访相关的各个方面。