Osseous complications of pediatric transplantation

[Guest guest]

Pediatr Transplant. 2004 Aug;8(4):400-15.

Osseous complications of pediatric transplantation.

Saland JM.

Department of Pediatrics, The Mount Sinai School of Medicine, New York, NY,

USA.

Saland JM. Osseous complications of pediatric transplantation. Pediatr

Transplantation 2004: 8: 400-415. Copyright 2004 Blackwell Munksgaard

Abstract: Adult stature and peak bone mass are achieved through childhood

growth and development. Multiple factors impair this process in children

undergoing solid organ transplantation, including chronic illness,

pretransplant osteodystrophy, use of medications with negative impact on

bone, and post-transplant renal dysfunction. While growth delay and short

stature remain common, the most severe forms of transplant-related bone

disease, fracture and avascular necrosis, appear to have become less common

in the pediatric age group. Osteopenia is very prevalent in adult transplant

recipients and probably also in pediatrics, but its occurrence and sequelae

are difficult to study in these groups due to methodological shortfalls of

planar densitometry related to short stature and altered patterns of growth

and development. Although the effect on lifetime peak bone mass is not

clear, data from adult populations suggest an elevated long-term risk of

bone disease in children receiving transplants. Optimal management of

pretransplantation osteodystrophy, attention to post-transplant renal

insufficiency among both renal and non-renal transplant patients, reduction

of steroid dose in select patients, and supplementation with calcium plus

vitamin D during expected periods of maximal bone loss may improve bone

health. Careful research is required to determine the role of bisphosphonate

therapy in pediatric transplantation.

PMID: 15265169 [PubMed - in process]

[Guest guest]

Pediatr Transplant. 2004 Aug;8(4):400-15.

Osseous complications of pediatric transplantation.

Saland JM.

Department of Pediatrics, The Mount Sinai School of Medicine, New York, NY,

USA.

Saland JM. Osseous complications of pediatric transplantation. Pediatr

Transplantation 2004: 8: 400-415. Copyright 2004 Blackwell Munksgaard

Abstract: Adult stature and peak bone mass are achieved through childhood

growth and development. Multiple factors impair this process in children

undergoing solid organ transplantation, including chronic illness,

pretransplant osteodystrophy, use of medications with negative impact on

bone, and post-transplant renal dysfunction. While growth delay and short

stature remain common, the most severe forms of transplant-related bone

disease, fracture and avascular necrosis, appear to have become less common

in the pediatric age group. Osteopenia is very prevalent in adult transplant

recipients and probably also in pediatrics, but its occurrence and sequelae

are difficult to study in these groups due to methodological shortfalls of

planar densitometry related to short stature and altered patterns of growth

and development. Although the effect on lifetime peak bone mass is not

clear, data from adult populations suggest an elevated long-term risk of

bone disease in children receiving transplants. Optimal management of

pretransplantation osteodystrophy, attention to post-transplant renal

insufficiency among both renal and non-renal transplant patients, reduction

of steroid dose in select patients, and supplementation with calcium plus

vitamin D during expected periods of maximal bone loss may improve bone

health. Careful research is required to determine the role of bisphosphonate

therapy in pediatric transplantation.

PMID: 15265169 [PubMed - in process]

[Guest guest]

Pediatr Transplant. 2004 Aug;8(4):400-15.

Osseous complications of pediatric transplantation.

Saland JM.

Department of Pediatrics, The Mount Sinai School of Medicine, New York, NY,

USA.

Saland JM. Osseous complications of pediatric transplantation. Pediatr

Transplantation 2004: 8: 400-415. Copyright 2004 Blackwell Munksgaard

Abstract: Adult stature and peak bone mass are achieved through childhood

growth and development. Multiple factors impair this process in children

undergoing solid organ transplantation, including chronic illness,

pretransplant osteodystrophy, use of medications with negative impact on

bone, and post-transplant renal dysfunction. While growth delay and short

stature remain common, the most severe forms of transplant-related bone

disease, fracture and avascular necrosis, appear to have become less common

in the pediatric age group. Osteopenia is very prevalent in adult transplant

recipients and probably also in pediatrics, but its occurrence and sequelae

are difficult to study in these groups due to methodological shortfalls of

planar densitometry related to short stature and altered patterns of growth

and development. Although the effect on lifetime peak bone mass is not

clear, data from adult populations suggest an elevated long-term risk of

bone disease in children receiving transplants. Optimal management of

pretransplantation osteodystrophy, attention to post-transplant renal

insufficiency among both renal and non-renal transplant patients, reduction

of steroid dose in select patients, and supplementation with calcium plus

vitamin D during expected periods of maximal bone loss may improve bone

health. Careful research is required to determine the role of bisphosphonate

therapy in pediatric transplantation.

PMID: 15265169 [PubMed - in process]

[Guest guest]

Pediatr Transplant. 2004 Aug;8(4):400-15.

Osseous complications of pediatric transplantation.

Saland JM.

Department of Pediatrics, The Mount Sinai School of Medicine, New York, NY,

USA.

Saland JM. Osseous complications of pediatric transplantation. Pediatr

Transplantation 2004: 8: 400-415. Copyright 2004 Blackwell Munksgaard

Abstract: Adult stature and peak bone mass are achieved through childhood

growth and development. Multiple factors impair this process in children

undergoing solid organ transplantation, including chronic illness,

pretransplant osteodystrophy, use of medications with negative impact on

bone, and post-transplant renal dysfunction. While growth delay and short

stature remain common, the most severe forms of transplant-related bone

disease, fracture and avascular necrosis, appear to have become less common

in the pediatric age group. Osteopenia is very prevalent in adult transplant

recipients and probably also in pediatrics, but its occurrence and sequelae

are difficult to study in these groups due to methodological shortfalls of

planar densitometry related to short stature and altered patterns of growth

and development. Although the effect on lifetime peak bone mass is not

clear, data from adult populations suggest an elevated long-term risk of

bone disease in children receiving transplants. Optimal management of

pretransplantation osteodystrophy, attention to post-transplant renal

insufficiency among both renal and non-renal transplant patients, reduction

of steroid dose in select patients, and supplementation with calcium plus

vitamin D during expected periods of maximal bone loss may improve bone

health. Careful research is required to determine the role of bisphosphonate

therapy in pediatric transplantation.

PMID: 15265169 [PubMed - in process]