Scoliosis after solid organ transplantation in children and adolescents.
The occurrence of scoliosis in children after solid organ transplantation is not known. A total of 196 children, which is 93% of patients surviving kidney, liver and heart transplantation in our country, participated in a cross-sectional survey. All children were screened for rib hump, and those with clinically significant hump (over 6 degrees ) underwent radiographs of the spine. The occurrence of scoliosis was compared to data obtained from a previously published comparison group. Forty-three (21.9%) of the patients had scoliosis greater than 10 degrees , and 21 (10.7%) of them had curves greater than 20 degrees . The RR (95% CI) for scoliosis needing treatment (over 20 degrees ) was 17.0 (6.75-42.7) in the patients as compared with control population. The occurrence of scoliosis was 17.9% of the kidney, 13.6% of the liver and 51.7% of the heart transplant patients (p < 0.001). In a logistic regression model, heart transplantation (OR (95% CI) 7.27 (2.62-20.2)) and growth hormone treatment (3.98 (1.77-8.94)) were most significant risk factors for scoliosis. The risk of scoliosis is increased in patients with solid organ transplantation. Pediatricians treating these patients should be aware of this increased risk to diagnose early curves and to refer these patients to an orthopedic surgeon.
Helenius
I
I
Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland. Ilkka_Helenius@helsinki.fi
Jalanko
H
H
Remes
V
V
Sairanen
H
H
Salminen
S
S
Holmberg
C
C
Palmu
P
P
Tervahartiala
P
P
Valta
H
H
Sarna
S
S
Helenius
M
M
Mäkitie
O
O
Peltonen
J
J
D000293:Adolescent; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D016027:Heart Transplantation / Q000009:adverse effects*; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012600:Scoliosis / Q000453:epidemiology*
D019382:Human Growth Hormone