Bone health and Growth in Children post Liver Transplant

Abstract

The study aim was to compare the impact of corticosteroid-free and corticosteroid-containing immunosuppressive regimes on parameters of bone health and growth in children post-liver transplant (LTX). One-hundred fifteen charts were screened, thirty-nine charts meeting study inclusion were reviewed. The prevalence of decreased lumbar and whole-body bone mineral density (BMD z-score <-2) was 15% and 8% respectively. Children on corticosteroid-free immunosuppressive regimens had greater height z-scores (0.23± 0.22 versus -0.71± 0.13, p=0.002) and whole-body bone mineral content (944± 88 versus 889 ± 57 g p<0.001) than those prescribed corticosteroids. A trend to lower absolute whole-body BMD (g/cm2) was observed in children on corticosteroid therapy for more than 365 days (p=0.055). While suboptimal vitamin K and calcium intakes may have contributed to poor bone health, vitamin D intakes (with supplementation) appeared to meet recommended levels. Low-dose corticosteroid therapy is associated with reduced BMC and linear growth in children post-LTX.