Does conversion of immunosuppressive monotherapy from cyclosporine a to tacrolimus improve bone mineral density in long-term stable liver transplant recipients?

Abstract

The effects of converting cyclosporine A to tacrolimus on bone mineral density (BMD) have not yet been evaluated thoroughly in liver transplant patients. Interfering factors in this patient population often are concomitant glucocorticoid treatment or exposure to estrogens. Here, we investigated in a homogeneous population of 10 male liver transplant recipients the impact of converting low-dose cyclosporine A monotherapy to low-dose tacrolimus monotherapy on BMD by using dual-energy x-ray absorptiometry. During the 12-month study period, an increase in BMD at the lumbar spine was observed in 9 out of 10 men ( P < .01), whereas BMD at the femoral neck remained stable. Converting cyclosporine A to tacrolimus appears to be safe and efficaceous with regard to maintaining or even increasing BMD in male liver transplant recipients.