Spinal surgery following organ transplantation: Clinical article

Kashif A. Shaikh, Gregory M. Helbig, Scott Shapiro, Mitesh V. Shah, Saad A. Khairi, Eric Horn

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Object. Organ transplantation for renal, liver, cardiac, and pulmonary failure has become more common in recent years, and patients are living longer as a result of improved organ preservation methods, immunosuppressive regimens, and general posttransplant care. Some of these patients undergo spine fusion surgery following organ transplantation, and there is little available information concerning outcomes. The authors report on their experience with and the outcomes of spine fusion in this rare and unique immunosuppressed patient group. Methods. Using the Current Procedural Terminology and ICD-9 codes for solid organ transplants, bone marrow transplantations (BMTs), and spine fusion surgeries, the authors searched their patient database between 1997 and 2008. Data points of interest included primary diagnosis, type of organ transplant, immunosuppressant drug therapy, complications from spine surgery, and radiographic analysis of spine fusion. Spine fusion was assessed with CT or radiography at the latest follow-up. Results. The database search results revealed 5999 patients who underwent heart, lung, liver, kidney, pancreas, intestine, or bone marrow transplant between 1997 and 2008. Eighteen of the 5999 patients underwent a spine fusion surgery while receiving immunosuppressive therapy. Organ transplants included kidney, liver, heart, pancreas, and allogenic BMT. There were 3 deaths unrelated to spine fusion within 1 year of the surgery and 1 death immediately after spine surgery. Graft-versus-host disease developed in 1 patient when prednisone was stopped prior to the spine surgery. Thirteen patients underwent follow-up radiographic imaging at an average of 25 months after spine surgery; 12 demonstrated radiographic fusion. Conclusions. The results suggest that spine fusion rates are adequate despite immunosuppressive therapy in patients undergoing spinal fusion after transplant procedures. The data also illustrate the high morbidity and mortality rates found in the organ transplant patient population.

Original languageEnglish
Pages (from-to)779-784
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume14
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Organ Transplantation
Spine
Immunosuppressive Agents
Transplants
International Classification of Diseases
Bone Marrow Transplantation
Kidney
Pancreas
Liver
Current Procedural Terminology
Databases
Organ Preservation
Lung
Spinal Fusion
Homologous Transplantation
Graft vs Host Disease
Prednisone
Radiography
Intestines
Heart Failure

Keywords

  • Immunosuppressant
  • Organ transplant
  • Spine fusion

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Spinal surgery following organ transplantation : Clinical article. / Shaikh, Kashif A.; Helbig, Gregory M.; Shapiro, Scott; Shah, Mitesh V.; Khairi, Saad A.; Horn, Eric.

In: Journal of Neurosurgery: Spine, Vol. 14, No. 6, 06.2011, p. 779-784.

Research output: Contribution to journalArticle

Shaikh, Kashif A. ; Helbig, Gregory M. ; Shapiro, Scott ; Shah, Mitesh V. ; Khairi, Saad A. ; Horn, Eric. / Spinal surgery following organ transplantation : Clinical article. In: Journal of Neurosurgery: Spine. 2011 ; Vol. 14, No. 6. pp. 779-784.
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abstract = "Object. Organ transplantation for renal, liver, cardiac, and pulmonary failure has become more common in recent years, and patients are living longer as a result of improved organ preservation methods, immunosuppressive regimens, and general posttransplant care. Some of these patients undergo spine fusion surgery following organ transplantation, and there is little available information concerning outcomes. The authors report on their experience with and the outcomes of spine fusion in this rare and unique immunosuppressed patient group. Methods. Using the Current Procedural Terminology and ICD-9 codes for solid organ transplants, bone marrow transplantations (BMTs), and spine fusion surgeries, the authors searched their patient database between 1997 and 2008. Data points of interest included primary diagnosis, type of organ transplant, immunosuppressant drug therapy, complications from spine surgery, and radiographic analysis of spine fusion. Spine fusion was assessed with CT or radiography at the latest follow-up. Results. The database search results revealed 5999 patients who underwent heart, lung, liver, kidney, pancreas, intestine, or bone marrow transplant between 1997 and 2008. Eighteen of the 5999 patients underwent a spine fusion surgery while receiving immunosuppressive therapy. Organ transplants included kidney, liver, heart, pancreas, and allogenic BMT. There were 3 deaths unrelated to spine fusion within 1 year of the surgery and 1 death immediately after spine surgery. Graft-versus-host disease developed in 1 patient when prednisone was stopped prior to the spine surgery. Thirteen patients underwent follow-up radiographic imaging at an average of 25 months after spine surgery; 12 demonstrated radiographic fusion. Conclusions. The results suggest that spine fusion rates are adequate despite immunosuppressive therapy in patients undergoing spinal fusion after transplant procedures. The data also illustrate the high morbidity and mortality rates found in the organ transplant patient population.",
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