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Osteoporosis in Organ Transplant Patients

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Principles of Osteoimmunology

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Abstract

Transplant osteoporosis has become a prevalent problem, as the numbers of patients receiving organ transplants and posttransplant survival have increased. Initially, transplant-related bone disease was considered to be due to glucocorticoid therapy. However, even after calcineurin inhibitors were introduced and glucocorticoid-sparing regimens adopted, patients continued to sustain rapid bone loss and fractures. In this chapter, we review both the evolution of and our current understanding of the effects of transplantation-immunosuppressive therapy on bone and mineral metabolism, as well as the potential effects of vitamin D in the immune system. We also review the epidemiology, natural history, and pathogenesis of bone loss and fracture in organ transplant candidates or recipients and summarize the results of therapeutic trials and make recommendations for prevention of bone loss during the initial acute phase following organ transplantation and treatment of established osteoporosis in organ transplant recipients.

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  1. Department of Medicine, Columbia University Medical Center, 630 west 168th street, PH8-864, New York, NY, 10032, USA

    Jessica Furst MD & Elizabeth Shane MD

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  2. Elizabeth Shane MD
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  1. Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria

    Peter Pietschmann

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Furst, J., Shane, E. (2016). Osteoporosis in Organ Transplant Patients. In: Pietschmann, P. (eds) Principles of Osteoimmunology. Springer, Cham. https://doi.org/10.1007/978-3-319-34238-2_11

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