title: Vitamin D in organ transplantation.
abstract: Vitamin D deficiency is prevalent among patients with end-stage organ failure awaiting transplant. Low serum 25-hydroxyvitamin D (25-OHD) levels in these patients may be related to many disease-specific factors, as well as decreased sunlight exposure and limited intake of foods containing vitamin D. Low serum 25-OHD levels are also extremely common following solid organ transplantation, both during the immediate postoperative period and in long-term graft recipients. Demographic and lifestyle factors are important in determining D status in transplant recipients. Worse vitamin D status is associated with poorer general health, lower albumin, and even decreased survival among these patients. Although several studies have demonstrated that active forms of vitamin D and its analogues prevent bone loss following transplantation, the data do not show consistent benefit. These therapies may have particular utility after renal transplantation. However, given the narrow therapeutic window with respect to hypercalcemia and hypercalciuria, and the demonstrated efficacy of bisphosphonates to prevent post-transplantation bone loss, we regard these agents as adjunctive rather than primary therapy for transplantation osteoporosis. The effects of 1,25(OH)(2)D on the immune system, which are still being elucidated, may have potential for reducing infections and preventing allograft rejection after transplantation.
authors.affiliation: Department of Medicine, Columbia University Medical Center, 630 West 168th Street, PH8-864, New York, NY 10032, USA. es2029@columbia.edu
authors.forename: E M
authors.initials: EM
authors.lastname: Stein
authors.forename: E
authors.initials: E
authors.lastname: Shane
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000188:drug therapy* / Q000517:prevention & control; D002762:Cholecalciferol / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004872:Ergocalciferols / Q000627:therapeutic use*; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D016040:Lung Transplantation / Q000009:adverse effects; D016377:Organ Transplantation / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy*
chemical_list: D050071:Bone Density Conservation Agents; D004872:Ergocalciferols; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D