Myeloma bone and extra-medullary disease: Role of PET/CT and other whole-body imaging techniques.

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Abstract

[Indexed for MEDLINE] 10. Pediatr Transplant. 2024 May;28(3):e14755. doi: 10.1111/petr.14755. Predictors for pathological bone fractures in children undergoing liver transplantation: A retrospective cohort study. Astolfi D(1), Rock N(1)(2), Ceroni D(3), Wildhaber BE(1)(4). Author information: (1)Department of Pediatrics, Gynecology, and Obstetrics, Swiss Pediatric Liver Center, University of Geneva, University Hospitals of Geneva, Geneva, Switzerland. (2)Pediatric Gastroenterology, Hepatology and Nutrition Unit, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. (3)Division of Child and Adolescent Surgery, Unit of Pediatric Orthopedics and Traumatology, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, University Hospitals of Geneva, Geneva, Switzerland. (4)Unit of Pediatric Surgery, Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, University Hospitals of Geneva, Geneva, Switzerland. BACKGROUND: Hepatic osteodystrophy refers to bone disorders associated with chronic liver disease, including children undergoing liver transplantation (LT). The aim of this study was to quantify the prevalence of pathological fractures (PF) in children before and after LT and to identify associated factors for their occurrence. METHODS: Children aged 0-18 years who underwent LT from 1/2005 to 12/2020 were included in this retrospective study. Data on patient demographics, types and anatomical locations of fracture and biological workups were extracted. Variables were assessed at 3 time points: T - 1 at the moment of listing for LT; T0 at the moment of LT and T + 1 at 1-year post-LT. RESULTS: A total of 105 children (49 [47%] females) were included in this study. Median age at LT was 19 months (range 0-203). Twenty-two patients (21%) experienced 65 PF, 11 children before LT, 10 after LT, and 1 before and after LT. The following variables were observed as associated with PF: At T - 1, low weight and height z-scores, and delayed bone age; at T0, low weight and height z-scores, high total and conjugated bilirubin; at T + 1, persistent low height z-score. Patients in the PF-group were significantly more under calcium supplementation and/or nutritional support at T - 1, T0 and T + 1. CONCLUSION: More than one in five children needing LT sustain a PF before or after LT. Patients with low weight and height z-scores and delayed bone age are at increased risk for PF. Nutritional support remains important, even if to date it cannot fully counteract the risks of PF. © 2024 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC. DOI: 10.1111/petr.14755