porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo200922-4porozendo-4100Research ArticleСтатьиArticlesДИНАМИКА МИНЕРАЛЬНОЙ ПЛОТНОСТИ КОСТИ У РЕЦИПИЕНТОВ ПОСЛЕ ПЕРЕСАДКИ ПЕЧЕНИDINAMIKA MINERAL'NOY PLOTNOSTI KOSTI U RETsIPIENTOV POSLE PERESADKI PEChENIErmakovaI P-MoysyukYa G-BuzulinaV P-KoliashviliT K-YaroshenkoE B-KornilovM N-PronchenkoI A-ShmerkoN P-200915082009122№2 (2009)24Copyright © Ermakova I.P., Moysyuk Y.G., Buzulina V.P., Koliashvili T.K., Yaroshenko E.B., Kornilov M.N., Pronchenko I.A., Shmerko N.P., 20092009Ermakova I.P., Moysyuk Y.G., Buzulina V.P., Koliashvili T.K., Yaroshenko E.B., Kornilov M.N., Pronchenko I.A., Shmerko N.P.Ermakova I.P., Moysyuk Y.G., Buzulina V.P., Koliashvili T.K., Yaroshenko E.B., Kornilov M.N., Pronchenko I.A., Shmerko N.P.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/4100

У 16 реципиентов в сроки 1-47 месяцев после трансплантации трупной печени (ОТП) дважды исследовали минеральную плотность кости (МПК). При первом обследовании у всех 9 реципиентов с первичным билиарным циррозом (ПБЦ; группа 1) и у 5 из 7 реципиентов (71%) с хроническими вирусными гепатитами (группа 2) выявлены остеопороз или остеопения в области осевого и периферического скелета. У реципиентов, впервые обследованных в сроки 1-7 месяцев после ОТП (подгруппы 1А и 2А), через 9±2,8 месяца отмечено увеличение МПК. В подгруппе 1А прирост МПК наблюдался только в осевом скелете (20,7±13,2 %; р=0,024), а в подгруппе 2А - и в осевом (10,5±2,7%; р=0,001), и в периферическом скелете (8,10±5,91%; p<0,05). У реципиентов, обследованных в сроки свыше 18 месяцев после трансплантации печени, прироста МПК не выявлено. Более того, у двух реципиентов с ПБЦ наблюдалось снижение МПК, что, возможно, было связано с дисфункцией трансплантата и введением в схему иммуносупрессии глюкокортикоидной терапии.

Axial and periferal bone mineral density (BMD) was estimated by DXA twice within 1-47 months in 16 patients following orthotopic liver transplantation (OLT). Osteoporosis and osteopenia of lumbar spine and hip were identified in the first examination of all 9 recipients (group 1) with primary biliary cirrhosis (PBC) and in 5 out of 7 (71%) patients with viral hepatitic cirrhosis (group 2). Recipients which were firstly examined within 1-7 months following OLT (subgroups 1A, 2A) through 9±2.8 months showed in 1A axial BMD elevation (on 20.7+13.2% ; P=0.024) and in 2A axial so as hip BMD elevation (on 10.5+2.7%;P=0.001 and 8.1+5.9%;P< 0.05). Recipients which were examined later 18 months after OLT demonstrated no increase in BMD (subgroups 1B and 2B). Moreover two of them with PBC showed decrease in BMD, probably, as a result of transplant dysfunction and immunosuppression with glucocorticoids.

ортотопическая трансплантация печениминеральная плотность костной тканипервичный билиарный циррозхронические вирусные гепатитыReferencesCollier J. Bone disorders in chronic liver disease. // Hepatology. 2007. V.46. P. 1271-1278.Collier J. Bone disorders in chronic liver disease. // Hepatology. 2007. V.46. P. 1271-1278.Compston J.E. Osteoporosis after liver transplantation.// Liver Transpl. 2003; V. 9. P 321-330.Compston J.E. Osteoporosis after liver transplantation.// Liver Transpl. 2003; V. 9. P 321-330.Crosbie O.M., Freaney R., McKenna M.J. et al. Predicting bone loss following orthotopic liver transplantation.// Gut. 1999; V. 44. P. 430-434.Crosbie O.M., Freaney R., McKenna M.J. et al. Predicting bone loss following orthotopic liver transplantation.// Gut. 1999; V. 44. P. 430-434.Eastell R., Dickson E.R., Hodgson S.F. et al. Rates of vertebral bone loss before and after liver transplantation in women with primary biliary cirrhosis.// J. Hepatology. 1991; V.14. P. 296-300.Eastell R., Dickson E.R., Hodgson S.F. et al. Rates of vertebral bone loss before and after liver transplantation in women with primary biliary cirrhosis.// J. Hepatology. 1991; V.14. P. 296-300.Floreani A., Fries W., Luisetto G. et al. Bone metabolism in ortopic liver transplantation: prospective study.// Liver Transpl. 1998; V.4. P. 311-319.Floreani A., Fries W., Luisetto G. et al. Bone metabolism in ortopic liver transplantation: prospective study.// Liver Transpl. 1998; V.4. P. 311-319.Gasser R.W. Cholestasis and metabolic bone disease - a clinical review.// Wien Med Wochenschr. 2008; V.158 (19-20). P. 553-557.Gasser R.W. Cholestasis and metabolic bone disease - a clinical review.// Wien Med Wochenschr. 2008; V.158 (19-20). P. 553-557.Guichelaar M.M.J., Kendall R., Malinchoc M. et al. Bone mineral density before and after OLT: long-term follow-up and predictive factors.// Liver Transplantation. 2006; V. 12. P. 1390-1402.Guichelaar M.M.J., Kendall R., Malinchoc M. et al. Bone mineral density before and after OLT: long-term follow-up and predictive factors.// Liver Transplantation. 2006; V. 12. P. 1390-1402.Mart G., Gomez R., Jodar E. et al. Long-term follow-up of bone mass after orthotopic liver transplantation: effect of steroid withdrawal from the immunosuppressive regimen.// Osteoporos Int. 2002; V. 13. P. 147-150.Mart G., Gomez R., Jodar E. et al. Long-term follow-up of bone mass after orthotopic liver transplantation: effect of steroid withdrawal from the immunosuppressive regimen.// Osteoporos Int. 2002; V. 13. P. 147-150.McDonald J.A., Dunstan C.R., Dilworth P. et al. Bone loss after liver transplantation.// Hepatology. 1991; V. 14(4Pt 1). P. 613-619.McDonald J.A., Dunstan C.R., Dilworth P. et al. Bone loss after liver transplantation.// Hepatology. 1991; V. 14(4Pt 1). P. 613-619.Monegal A., Navasa M., Guanabens N. et al. Bone disease after liver transplantation: a long-term prospective study of bone mass changes, hormonal disorders and histomorphometric characteristics.// Osteoporos Int. 2001; V12. P. 484-492.Monegal A., Navasa M., Guanabens N. et al. Bone disease after liver transplantation: a long-term prospective study of bone mass changes, hormonal disorders and histomorphometric characteristics.// Osteoporos Int. 2001; V12. P. 484-492.Monegal A., Navasa M., Guanabens N. et al. Bone mass and mineral metabolism in liver transplant patients treated with FK506 or cyclosporine A.// Calcif Tissue Int. 2001; V. 68. P. 83-86.Monegal A., Navasa M., Guanabens N. et al. Bone mass and mineral metabolism in liver transplant patients treated with FK506 or cyclosporine A.// Calcif Tissue Int. 2001; V. 68. P. 83-86.Mounach A., Ouzzif Z., Wariaghli G. et al. Primary biliary cirrhosis and osteoporosis: a case-control study // J Bone Miner Metab. 2008; V. 26. P. 379-384.Mounach A., Ouzzif Z., Wariaghli G. et al. Primary biliary cirrhosis and osteoporosis: a case-control study // J Bone Miner Metab. 2008; V. 26. P. 379-384.Newton J., Francis R., Prince M. et al. Osteoporosis in primary biliary cirrhosis revisited.// Gut. 2001; V. 49. P. 282-287.Newton J., Francis R., Prince M. et al. Osteoporosis in primary biliary cirrhosis revisited.// Gut. 2001; V. 49. P. 282-287.Segal E., Baruch Y., Kramsky R. et al. Predominant factors associated with bone loss in liver transplant patients - after prolonged posttransplantation period.// Clin. Transplant. 2003; V. 17(1). P. 13-19.Segal E., Baruch Y., Kramsky R. et al. Predominant factors associated with bone loss in liver transplant patients - after prolonged posttransplantation period.// Clin. Transplant. 2003; V. 17(1). P. 13-19.Trautwein C., Possienke M., Schlitt H.J. et al. Bone density and metabolism in patients with viral hepatitis and cholestatic liver diseases before and after liver transplantation.// Am. J Gastroenterol. 2000; V. 95. P. 2343-2351.Trautwein C., Possienke M., Schlitt H.J. et al. Bone density and metabolism in patients with viral hepatitis and cholestatic liver diseases before and after liver transplantation.// Am. J Gastroenterol. 2000; V. 95. P. 2343-2351.

The authors declare that there are no conflicts of interest present.