Bone Health Outcomes in Post-Lung Transplant Patients with Cystic Fibrosis

dc.contributor.advisorMaalouf, Naim M.en
dc.contributor.committeeMemberJain, Rakshaen
dc.contributor.committeeMemberLederer, Eleanor D.en
dc.creatorTran, Triet Vincent Minhen
dc.creator.orcid0000-0001-7481-9914 2023
dc.description.abstractBACKGROUND: Osteoporosis is a common comorbidity in patients with cystic fibrosis (CF). Although lung transplantation (LTx) improves quality of life of CF patients, there is little research examining long-term bone health outcomes following LTx in these patients. OBJECTIVE: We sought to compare long-term bone health outcomes in LTx patients with and without CF, as well as determine factors associated with adverse bone health in CF patients. METHODS: Data were collected on 59 patients who underwent LTx between 2006-2019, including 30 with CF and 29 without CF. We compared baseline characteristics, long-term bone mineral density (BMD) trends, and fracture incidence between the two patient populations, and examined factors associated with post-LTx fractures in CF patients. RESULTS: Compared with non-CF patients, patients with CF were younger, had lower body mass index, and lower baseline BMD Z-scores at the lumbar spine, femoral neck, and total hip (all p<0.001). BMD at all sites declined in both groups in the first year post-LTx. In subsequent years, CF patients exhibited better BMD recovery relative to pre-transplantation, but continued to have lower BMD post-LTx. Post-transplant fractures occurred in 30% and 34% of CF and non-CF patients, respectively. CF patients who developed fractures after LTx had significantly lower BMD and lower pre-transplantation percent predicted forced expiratory volume in one second (FEV1%). CONCLUSION: Although CF patients exhibit better BMD recovery following LTx compared to their non-CF counterparts, CF patients start with significantly lower pre-LTx BMD and experience a similarly high rate of post-LTx fractures. These findings highlight the unique contribution of the CF disease process to bone health, as well as a clear need for better prevention and treatment of osteoporosis in CF patients before and after LTx.en
dc.subjectCystic Fibrosisen
dc.subjectLung Diseasesen
dc.subjectLung Transplantationen
dc.subjectOsteoporotic Fracturesen
dc.subjectBone Densityen
dc.titleBone Health Outcomes in Post-Lung Transplant Patients with Cystic Fibrosisen
dc.type.materialtexten Southwestern Medical Schoolen Southwestern Medical Centeren with Distinctionen


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