Bone disease in liver transplant recipients.

Osteopenic bone disease with atraumatic fracturing is a major cause of morbidity in liver transplant recipients. The course of bone loss after transplantation is biphasic, consisting of an early phase with acute loss of bone followed by stabilization or even improvement in bone density. The pathophysiology of the osteopenia is poorly understood, and treatment is supportive. Osteonecrosis is a second, less common skeletal complication after liver transplantation, assumed to be related to the use of corticosteroids.