Severe vitamin D deficiency among heart and liver transplant recipients
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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Liver transplant 13.5 ng : liver is part of the vitamin D supply stream
Heart transplant 19 ng a transplanted heart is merely a consumer of vitamin D
Chart from the paper
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