Osteoporosis in lung transplant patients

Glucocorticoids are commonly used drugs in various lung diseases. Using them combined with low physical activity and other comorbidities result in a high percentage of osteoporosis in these patients. Some of these patients then end up having lung transplants, which are treated with high doses of corticoids . Here we present a retrospective analysis in which we study the prevalence of osteopenia and osteoporosis in patients who were treated with pulmonary transplant, measured by densitometry (gr/cm2 and T-score, at lumbar region, neck femur and total femur) and following the WHO criteria at different moments: pre-transplant and post-transplant (6, 12, 18, 24, 36, 48, 60 months). We have a total of 227 patients (34.80% women and 65.19% men). The age average was 53,86 years (± 10.84). Bilateral lung transplant (68.72%), unipulmonar transplant (30.39%), cardiopulmonar (0.44%). The results that we obtained were analysed by age, gender, treatment, base lung pathology and number of rejections in the first year. We observed a high prevalence of low bone mineral density pre-transplant (osteoporosis 48.48%, osteopenia 35.60%). After the transplant there was also a high osteoporosis and osteopenia prevalence in all groups (Osteoporosis+Osteopenia; 85.82%, 91.95%, 86.01%, 90.69%, 91.07%, 85.41%, 80.95% at 6, 12, 18, 24, 36, 48, 60 months respectively. Patients analysed at 5 years were younger than the others). There was a bigger percentage of women and older people who have osteoporosis and osteopenia. In conclusion most patients that need a pulmonary transplant already have a low bone mineral density, this condition remains and worsens most likely due to glucocorticoids as a primary treatment, low physical activity and comorbidities.