LIVER transplant patients face a substantial risk of bone fractures despite following specialized care protocols, according to new findings. The study underscores the urgent need for targeted bone health strategies following transplantation and introduces a fracture risk prediction score with promising accuracy.
The research evaluated 220 liver transplant recipients over a 7-year period under a multidisciplinary care protocol designed to prevent fragility fractures. Despite proactive bone health measures, 10.9% of patients experienced fractures within the first year post-transplant.
The study highlights that pre-transplant bone health is often already compromised. At the time of liver transplantation, 47% of patients had osteopenia and 30% had osteoporosis in critical areas such as the lumbar spine and femoral regions. Furthermore, nearly one-quarter had a history of fragility fractures even before receiving their transplant.
Key fracture risk factors identified include being over 50 years of age, a personal history of fractures, and postmenopausal status in women. These variables formed the basis for a newly developed fracture risk score. The model showed 80% sensitivity and 72% specificity, offering clinicians a practical tool for identifying high-risk patients and customizing therapeutic approaches.
The findings reinforce the importance of pre- and post-transplant bone health assessments, and they suggest that a more tailored intervention could improve outcomes for vulnerable individuals. Researchers call for further validation of the risk score and stress the continued need for multidisciplinary care to mitigate bone loss and fractures in this complex patient population.
Reference:
Monegal A et al. Results of the implementation of a multidisciplinary care protocol for preventing fragility fractures following liver transplantation. Osteoporos Int. 2025. [Online ahead of print]. doi:10.1007/s00198-025-07525-x.
