ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Vertebral fracture incidence and risk factors following liver transplantation: tertiary transplant center experience.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Management of bone health in adult solid organ transplant recipients: a multidisciplinary care pathway.Clinical transplantation and research · 2026Article
- Liver transplantation-related osteoporosis and fragility fractures: pathogenic pathways, risk stratification and novel targeted therapy advances.Frontiers in immunology · 2026Review
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10 authors.
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Abstract
backgroundPost-transplantation bone disease has been established as a common consequence of solid organ transplant. This study aims to assess the incidence and risk factors of vertebral compression fractures following liver transplant surgery in a tertiary transplant care center.
methodsRetrospective electronic audit included all patients undergoing liver transplant surgery at a tertiary transplant center, from 2016 to 2020, with at least 3 years of follow-up. Pre- and Post-transplant Data were collected. The Kaplan-Meier statistic was used to estimate the cumulative incidence of fractures. Statistical significance was determined by two-tailed P-values < 0.05.
results434 patients were included in the audit, with a mean follow-up of 46.5 months. Vertebral fracture incidence was 8.3%, with most being at the thoracolumbar junction. The first year post-transplant recorded the highest fracture incidence rate with a mean of 10.5 months. The majority of patients were either osteoporotic or osteopenic pre and post-transplant. The utilization of bone protective medications was low pre- and posttransplant, at 11% and 18%, respectively. The mean duration of glucocorticoid use was 26 months. Post-transplant use and duration of prednisoloneand other immunosuppressant medications showed no significant association with fracture incidence. Pre-transplant osteoporosis was predictive for vertebral fracture posttransplant (p = 0.011).
conclusionOur audit reveals a higher incidence of vertebral compression fractures following liver transplant compared to recently published data. The risk seems to be highest soon after the transplant. Post-transplantation bone disease prevention should focus on optimizing bone mass prior to transplantation and preventing bone loss in the early postoperative period.
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