Promoting bone health in children and adolescents following solid organ transplantation.

Title

Promoting bone health in children and adolescents following solid organ transplantation.

Creator

Kusumi K; Shaikhkhalil A; Patel HP; Mahan John D

Publisher

Pediatric Transplantation

Date

2020
2020-12-19

Description

Solid organ transplantation in children and adolescents provides many benefits through improving critical organ function, including better growth, development, cardiovascular status, and quality of life. Unfortunately, bone status may be adversely affected even when overall status is improving, due to issues with pre-existing bone disease as well as medications and nutritional challenges inherent post-transplantation. For all children and adolescents, bone status entering adulthood is a critical determinant of bone health through adulthood. The overall health and bone status of transplant recipients benefits from attention to regular physical activity, good nutrition, adequate calcium, phosphorous, magnesium and vitamin D intake and avoidance/minimization of soda, extra sodium, and obesity. Many immunosuppressive agents, especially glucocorticoids, can adversely affect bone function and development. Minimizing exposure to "bone-toxic" medications is an important part of promoting bone health in children post-transplantation. Existing guidelines detail how regular monitoring of bone status and biochemical markers can help detect bone abnormalities early and facilitate valuable bone-directed interventions. Attention to calcium and vitamin D supplementation, as well as tapering and withdrawing glucocorticoids as early as possible after transplant, can provide best bone outcomes for these children. Dual-energy X-ray absorptiometry can be useful to detect abnormal bone mass and fracture risk in this population and newer bone assessment methods are being evaluated in children at risk for poor bone outcomes. Newer bone therapies being explored in adults with transplants, particularly bisphosphonates and the RANKL inhibitor denosumab, may offer promise for children with low bone mass post-transplantation.

Subject

bisphosphonates; bone; calcium; magnesium; metabolic bone disease; phosphorous; physical activity; solid organ transplant; vitamin D

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

e13940

ISSN

1399-3046 1397-3142

NEOMED College

NEOMED College of Medicine

NEOMED Department

Department of Pediatrics

Update Year & Number

January 2021 List

Affiliated Hospital

Akron Children's Hopsital

Citation

Kusumi K; Shaikhkhalil A; Patel HP; Mahan John D, “Promoting bone health in children and adolescents following solid organ transplantation.,” NEOMED Bibliography Database, accessed March 5, 2021, https://neomed.omeka.net/items/show/11504.

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