Severe vitamin D deficiency among heart and liver transplant recipients.
BACKGROUND
Although patients with end-stage organ failure are at high risk for vitamin D deficiency because of limited sunlight exposure and hepatic dysfunction, few studies have measured 25-hydroxy vitamin D (25OHD) at the time of transplantation.


METHODS
We measured serum 25OHD immediately after transplantation in 69 heart and liver transplant recipients.


RESULTS
Forty-six heart and 23 liver transplant recipients were evaluated (mean age 53 yr). Mean 25OHD was well below the lower limit of the normal range (43.2 +/- 21.2 nmol/L). Ninety-one percent had levels below 75 nmol/L, the threshold commonly used to denote sufficiency, and 71% had levels below 50 nmol/L. Severe deficiency (25OHD <25 nmol/L) was found in 16%. Vitamin D levels did not differ by race, age, gender, or season. Mean 25OHD was lower among liver than heart transplant recipients (34.4 +/- 17.5 vs. 47.7 +/- 20.7 nmol/L; p < 0.03). Among liver transplant recipients, 22% had undetectable levels (<17 nmol/L).


CONCLUSIONS
Vitamin D deficiency is highly prevalent among heart and liver transplant recipients; those with liver failure are at greatest risk. As vitamin D deficiency has many serious skeletal and extra-skeletal sequelae, physicians who treat transplant patients should maintain a high degree of vigilance for this problem.
Stein
Emily M
EM
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Cohen
Adi
A
Freeby
Matthew
M
Rogers
Halley
H
Kokolus
Shannon
S
Scott
Vanessa
V
Mancini
Donna
D
Restaino
Susan
S
Brown
Robert
R
McMahon
Donald J
DJ
Shane
Elizabeth
E
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000097:blood / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
D014807:Vitamin D; C104450:25-hydroxyvitamin D