Monthly Ibandronate for the Prevention of Bone Loss in Patients After Liver Transplantation

Background. Osteopenia and osteoporosis are diseases frequently occurring after liver transplantation (OLT). Purpose. In a prospective study, we have investigated the effect of ibandronate, vitamin D-3, and calcium on the prevention and treatment of posttransplant osteopenia and osteoporosis. Methods. The bone mineral density (BMD) of the lumbar spine (LS) and of the femoral neck (FN) were measured in 74 patients prospectively pre- and post-OLT. Results. Postoperatively the study group showed a consistent percentage increase in BMD (g/cm(2)) and a significantly increased BMD after 12 and 24 months in the LS (12 months: 1.05 +/- 0.21 g/cm(2); P < .001 24 months: 1.11 +/- 0.19 g/cm(2); P < .001) and the FN (12 months: 0.88 +/- 0.16 g/cm(2); P < .002 24 months: 0.90 +/- 0.15 g/cm(2); P <.001) in comparison with baseline pre-OLT (LS pre-OLT 0.98 +/- 0.19 g/cm(2), FN 0.86 +/- 0.14 g/cm(2)). The overall bone fracture rate was 5.4% up to 24 months. Conclusion. Ibandronate once monthly per os significantly increased the BMD in the LS and FN after OLT at 12 and 24 months. The increased BMD limits the risk of fracture.