title: Spine after solid organ transplantation in childhood: a clinical, radiographic, and magnetic resonance imaging analysis of 40 patients.
abstract: METHODS
  A cross-sectional study of the spine in 40 young adults after solid organ transplantation in childhood.
  
  
  OBJECTIVE
  To evaluate the impact of organ transplantation and long-term immunosuppressive treatment on growing spine using magnetic resonance imaging (MRI).
  
  
  BACKGROUND
  A review of the current literature reveals no systematic evaluation of the spine after transplantation in childhood.
  
  
  METHODS
  A total of 40 adult patients (mean age 22.1 years, range, 16.0-27.0), who received either kidney, liver, or heart transplant as children, were evaluated. Mean follow-up after transplantation was 11.2 years (range 3.0-18.0). All patients filled in a questionnaire, underwent an interview and physical examination, as well as had MRI of the spine. Standing spinal radiographs were taken from patients with a rib hump > or = 6 degrees.
  
  
  RESULTS
  There were 8 (20%) patients who had a history of vertebral fracture. Eleven (28%) patients reported frequent back pain at rest. There were 15 (38%) patients who had scoliosis > 10 degrees (range 10 degrees -69 degrees ). On MRI, narrowed disc spaces were noted in 32 (80%) patients, and irregular endplates were noted in 24 (60%). There were 14 (35%) patients who had at least 1 compressed or wedged vertebra (> 20%). Patients treated for acute rejection had wedged vertebrae, speckled or black disc spaces, and irregular endplates more often than patients without rejections. Males had wedged vertebrae more often than females (P = 0.0067).
  
  
  CONCLUSIONS
  Back pain, scoliosis, wedged vertebrae, and narrowed, degenerated disc spaces are common after solid organ transplantation in childhood.
authors.affiliation: Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland. ilkka.helenius@helsinki.fi
authors.forename: Ilkka
authors.initials: I
authors.lastname: Helenius
authors.forename: Ville
authors.initials: V
authors.lastname: Remes
authors.forename: Pekka
authors.initials: P
authors.lastname: Tervahartiala
authors.forename: Sari
authors.initials: S
authors.lastname: Salminen
authors.forename: Heikki
authors.initials: H
authors.lastname: Sairanen
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Petri
authors.initials: P
authors.lastname: Palmu
authors.forename: Miia
authors.initials: M
authors.lastname: Helenius
authors.forename: Jari
authors.initials: J
authors.lastname: Peltonen
authors.forename: Hannu
authors.initials: H
authors.lastname: Jalanko
mesh_terms: D000293:Adolescent; D000328:Adult; D001416:Back Pain / Q000209:etiology / Q000503:physiopathology; D015519:Bone Density / Q000187:drug effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007405:Intervertebral Disc Displacement / Q000209:etiology / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications; D011859:Radiography; D012600:Scoliosis / Q000209:etiology / Q000503:physiopathology; D013122:Spinal Diseases / Q000209:etiology* / Q000503:physiopathology; D016103:Spinal Fractures / Q000209:etiology / Q000503:physiopathology; D013168:Spondylolisthesis / Q000209:etiology / Q000503:physiopathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents