Author(s):
Pereira, S. 
; Pedroso, S. ; Martins, L. ; Santos, P. ; Almeida, M. ; Freitas, C. ; Dias, L. ; Dores, J. ; Almeida, R. ; Henriques, A.C. ; Teixeira, M.
Date: 2010
Persistent ID: http://hdl.handle.net/10400.16/278
Origin: Repositório Científico do Centro Hospitalar do Porto
Description
ABSTRACT
Bone disease and an high risk of fractures are major problems in transplantation. Among
diabetic patients undergoing simultaneous kidney–pancreas (SKP) transplantation, there
are few studies assessing long-term effects on bone mass. The aim of this study was to
evaluate bone mineral density (BMD) over 4 years follow-up after SKP transplantation.
Fifty-seven patients had 22.8 5.3 years of prior diabetes, 65% were female, and the
overall mean age was 24.3 5.93 years. At the time of transplantation, the lumbar spine
and femoral neck T-scores were 1.75 1.05 and 1.95 0.73, respectively; 28% of
subjects had evidence of osteoporosis. One year after transplantation, 77.6% of patients
displayed improved lumbar T-scores to 1.33 0.94 (.044) with stable femoral neck
T-scores. Bone densitometry enhanced gradually through the 4 years follow-up: lumbar
T-score to 1.04 0.67 (.004) and femoral neck T-score to 1.69 0.49 (.12).
At year 4, no osteoporosis cases were detected but 86.7% of patients did not receive
steroids in the immunosuppressive regimen. The graft function remained stable (serum
creatinine, 1.2 mg/dL; fasting glucose, 87.7 mg/dL). During the follow-up, BMD improved
more significantly at cortical sites. Our study reports a reduced prevalence of fractures
(8.7%) compared with the literature, which could be related to a steroid-sparing protocol
and/or aggressively treatment of osteoporosis.
