A NEWLY published study recommends annual DXA screenings for patients in the first 2 years after lung transplants to monitor bone mineral density (BMD) changes. Lung transplant patients are at heightened risk for reduced BMD, often resulting in osteopenia, osteoporosis, and fracture risks, due to transplant-related factors like corticosteroid therapy.
Researchers reviewed DXA results for 259 lung transplant recipients over a median period of 725 days. Findings reveal that 65% of the cohort already had osteopenia or osteoporosis prior to their transplant. Male patients exhibited higher baseline BMD compared to females, while post-transplant, the femoral neck displayed the fastest rate of BMD reduction across all patients. Intriguingly, those with low BMD pre-transplant experienced slower BMD declines compared to patients with initially normal BMD levels, potentially due to increased bisphosphonate therapy utilization, approximately four times more likely in these patients.
Significant BMD changes were predicted to occur at the femoral neck within 409 days post-transplant, with subsequent changes expected at approximately 867 days. The study emphasized that, in alignment with current International Society for Heart and Lung Transplantation (ISHLT) guidelines, annual DXA screenings are optimal for these patients within the first 2 post-transplant years. Early and consistent monitoring could help mitigate fracture risks and improve long-term outcomes in lung transplant recipients.
Reference: Sebro R, Elmahdy M. Optimized surveillance frequency for low bone mineral density (BMD) screening using dual energy X-ray absorptiometry (DXA) in patients after lung transplant. JHLT. 2024. (In press)
