Bone mineral density in heart transplant recipients. A retrospective study.

Survival has increased steadily in heart transplant recipients since the in troduction of cyclosporin. As a result, these patients are being increasing ly exposed to the complications of corticosteroid therapy including osteopo rosis, which is a major source of morbidity. Objective: to retrospectively evaluate the potential effects of heart transplantation and concomitant tre atments on lumbar spine and femoral bone mineral density. Patients and meth ods: lumbar spine and femoral bone mineral density (BMD) was measured using dual-energy absorptiometry (Sophos XRA) in patients who were on a heart tr ansplant waiting list or had received a heart transplant between 1991 and 1 995. Results. a) 51 patients evaluated prior to heart transplantation had o steopenia at the lumbar but not the femoral site: b) 17 patients had a BMD decrease at the femoral but not the lumbar site after as compared to before heart transplantation, uncorrelated to the cumulative corticosteroid dose; c) 10 patients had a significant increase in BMD at the lumbar but not the femoral site between the twelfth and twenty-sixth month after transplantat ion; d) 10 patients showed no significant BMD changes between the twenty-fo urth and forty-sixth months after heart transplantation. Conclusion: heart transplantation is associated with changes in ED, and patients at highrisk for osteoporosis should be evaluated prior to transplantation to allow init iation of prophylactic or therapeutic measures as appropriate. New therapeu tic strategies need to be developed and evaluated.