Endocrine Abstracts (2017) 49 EP259 | DOI: 10.1530/endoabs.49.EP259

Vitamin D prescribing bias in liver transplant referrals

KJ Gan1, Niamh O’Sullivan2, Bernadette Hanley1, Paul Armstrong1, Mark Kilbane1, Diarmaid Houlihan2 & Rachel Crowley1


1Department of Endocrinology, St Vincents University Hospital, Dublin, Ireland; 2Department of Hepatology, St Vincents University Hospital, Dublin, Ireland.


Vitamin D (VD) deficiency (25 OHD < 50 nmol/l) is common is chronic liver disease at 64%–92% regardless of aetiology. The only guidelines for routine VD supplementation are for cholestatic (C) liver disease; a population considered being at high risk of low bone mineral density (BMD). BMD decreases further following orthotopic liver transplant (OLT). To assess VD intake in an at risk population, retrospective analysis of intake was performed in OLT patients with C liver disease; this was excellent at 81%. Prospective analysis comparing C with non-cholestatic (NC) patients at time of dietetics referral at OLT assessment was then undertaken (n=94, 27% C and 73% NC). Median 25OHD in C patients was 86.7 nmol/l compared to 24.7 nmol/l in NC (P 0.001). 36% of C patients compared to 76% of NC had 25OHD measurement of <50 nmol/l (P <0.0001). 48% of C patients compared to 16% of NC were receiving VD supplementation before OLT assessment. We have observed a prescription bias at referral to transplant hepatology; VD is prescribed more frequently to C than NC patients with end-stage liver disease, although both populations are at risk of reduced BMD.

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