Bone Health in Young Lung Transplant Recipients: A Retrospective Study

Introduction: There are limited data on the prevalence and treatment of low bone density in young lung transplant recipients (LTRs), even though osteoporosis is common in patients with end-stage lung disease and transplant recipients. This study aimed to assess bone health in young LTRs. METHODS: We retrospectively reviewed medical records for LTRs aged 18-50 at transplant. Outcomes included posttransplant low bone density (Z score < -2), osteoporotic fractures, and treatment data. RESULTS: Among 150 LTRs (45% female, mean age 38 ± 9 years), with a median follow-up of 6.2 years, 103 (69%) underwent bone density scans; 82 occurred within the first year posttransplant. Of these, 19 (23%) showed low bone density within the first year. Posttransplant osteoporotic fractures occurred in 34 patients (23%), including femoral neck (32%) and vertebral fractures (29%) as first events. Eleven patients (32%) experienced multiple fractures. Pretransplant fracture history significantly predicted posttransplant fractures (HR 6.720, 95% CI: 1.572-28.724). Osteoporosis treatment was given to 41 patients (27%), primarily with bisphosphonates (93% as first line). Of those treated, 49% remained fracture free during follow-up. CONCLUSION: Young LTRs face high rates of low bone density and fractures, including serious and recurrent fractures. These findings underscore the need for early screening and intervention to reduce osteoporosis-related morbidity in this vulnerable population. .