Emily M. Stein, Adi Cohen, Matthew Freeby, Halley Rogers, Shannon Kokolus, Vanessa Scott, Donna Mancini, Susan Restaino, Robert Brown, Donald J. McMahon, and Elizabeth Shane ; es54 at columbia.edu, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
Clin Transplant. 2009 Nov-Dec; 23(6): 861–865.
Published online 2009 April 23. doi: 10.1111/j.1399-0012.2009.00989.x
Introduction: Although patients with end-stage organ failure are at high risk for vitamin D deficiency because of limited sunlight exposure and hepatic dysfunction, few studies have measured 25-hydroxy vitamin D (25OHD) at the time of transplantation.
Methods: We measured serum 25OHD immediately after transplantation in 69 heart and liver transplant recipients.
Results: Forty-six heart and 23 liver transplant recipients were evaluated (mean age 53 yr). Mean 25OHD was well below the lower limit of the normal range (43.2 ± 21.2 nmol/L).
Ninety-one percent had levels below 75 nmol/L, the threshold commonly used to denote sufficiency, and 71% had levels below 50 nmol/L. Severe deficiency (25OHD <25 nmol/L) was found in 16%. Vitamin D levels did not differ by race, age, gender, or season. Mean 25OHD was lower among liver than heart transplant recipients (34.4 ± 17.5 vs. 47.7 ± 20.7 nmol/L; p < 0.03). Among liver transplant recipients, 22% had undetectable levels (<17 nmol/L).
Conclusions: Vitamin D deficiency is highly prevalent among heart and liver transplant recipients; those with liver failure are at greatest risk. As vitamin D deficiency has many serious skeletal and extra-skeletal sequelae, physicians who treat transplant patients should maintain a high degree of vigilance for this problem.
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