Diagnosis and monitoring of post-transplantation osteopathies

The skeletal status of transplant recipients needs routine assessment both before and after organ transplantation for the following questions: 1) is the patient on risk for developing osteoporosis independently of transplantation? 2) are there signs of significant pre-transplantation bone disease? 3) does the patient develop posttransplantation osteopathy? Although biochemical markers of bone metabolism provide useful data to each of these questions, the complex metabolic pertubations seen in chronic organ failure make it mandatory to interpret biochemical findings only within the framework of other clinical tests and imaging techniques. Pre-transplantation osteopathies require specific and often broad clinical and laboratory evaluation, and biochemical tests should be chosen according to the underlying disease and type of organ failure. In this respect, biochemical markers of bone metabolism may provide information on the degree of the skeletal dysbalance. Likewise, biochemical markers of bone turnover may be helpful in monitoring skeletal metabolism after organ transplantation.