Symptomatic osteonecrosis of the hip after orthotopic liver transplantation

Patients who require long-term use for immunosuppression after organ transp lantation are at risk for the development of osteonecrosis. The purpose of this study was to determine the prevalence of symptomatic osteonecrosis of the hip in patients who were managed with corticosteroids for immunosuppres sion after orthotopic liver transplantation. We reviewed the relationship o f the administration and dosage of steroids in 203 patients who underwent o rthotopic liver transplantation. Overall, 29 of the 203 patients (14%) comp lained of hip pain, but only 3 patients (2%) developed symptomatic osteonec rosis of the hip. The osteonecrosis was diagnosed an average of 31 months a fter transplantation (range, 26-38 months). There was no association noted between steroid dose and the development of osteonecrosis. Routine screenin g for osteonecrosis of asymptomatic liver transplant patients is not necess ary.