title: Early increase in plasma parathyroid hormone levels following liver transplantation.
abstract: OBJECTIVE
  The pathogenesis of post-transplantation bone loss is poorly understood, although glucocorticoid therapy is believed to play an important role. In the present study we have measured plasma parathyroid hormone concentrations in the first few months after orthotopic liver transplantation, in order to examine the potential contribution of hyperparathyroidism to bone disease.
  
  
  METHODS
  Twenty-seven patients aged 32-54 years, 12 male, undergoing liver transplantation were studied prospectively before and for 3 months after operation. Plasma parathyroid hormone and serum 25-hydroxyvitamin D concentrations were measured by radioimmunoassay.
  
  
  RESULTS
  Plasma parathyroid hormone levels were normal in all but two patients prior to transplantation. There was a highly significant increase in plasma parathyroid hormone concentrations at 1 and 2 months (p < 0.0005 and 0.001, respectively, versus baseline); by 3 months, values were close to those obtained preoperatively. Serum 25-hydroxyvitamin D concentrations showed no significant change over the study period. However, 74% of the patients had subnormal values at baseline.
  
  
  CONCLUSIONS
  An early and transient increase in plasma parathyroid hormone after liver transplantation may be responsible for the high rates of bone loss which occur during the first few post-operative months. Prevention of post-transplantation bone disease is most likely to be achieved by peri-operative intervention with an anti-resorptive agent.
authors.affiliation: Department of Medicine, University of Cambridge School of Clinical Medicine, UK.
authors.forename: J E
authors.initials: JE
authors.lastname: Compston
authors.forename: S
authors.initials: S
authors.lastname: Greer
authors.forename: S J
authors.initials: SJ
authors.lastname: Skingle
authors.forename: D M
authors.initials: DM
authors.lastname: Stirling
authors.forename: C
authors.initials: C
authors.lastname: Price
authors.forename: P J
authors.initials: PJ
authors.lastname: Friend
authors.forename: G
authors.initials: G
authors.lastname: Alexander
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood / Q000209:etiology*; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology*; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D