Scoliosis After Liver Transplantation in Pediatric Patients

Nurullah Dağ; Mehmet Öztürk; Ahmet  Sığırcı; Sezai Yılmaz

doi:10.5152/EurJTher.2022.21081

Authors

Nurullah Dağ 1Department of Radiology, Malatya Training and Research Hospital, Malatya, Turkey https://orcid.org/0000-0002-9342-0244
Mehmet Öztürk Department of Pediatric Radiology, Selçuk University Faculty of Medicine, Konya, Turkey https://orcid.org/0000-0001-5585-1476
Ahmet Sığırcı Department of Pediatric Radiology, İnönü University Faculty of Medicine, Malatya, Turkey https://orcid.org/0000-0001-9221-0002
Sezai Yılmaz İnönü University, Institute of Liver Transplantation, Malatya, Turkey https://orcid.org/0000-0002-8044-0297

DOI:

https://doi.org/10.5152/EurJTher.2022.21081

Keywords:

Liver transplantation, musculoskeletal system, pediatric, scoliosis

Abstract

Objective: Little is known about the development of scoliosis after pediatric liver transplantation. In this study, we aimed to evaluate the frequency of scoliosis and its relationship with potential risk factors in children after liver transplantation.

Methods: Pediatric liver transplantations (under of age 18) performed between January 2009 and December 2017 at Malatya İnönü University Institute of Liver Transplantation were scanned retrospectively. In the spinal axis, >10° lateral deviations were accepted as scoliosis. The curve patterns were classified according to the Lenke classification.

Results: Among 287 pediatric liver transplantationss, 17 of them were scoliosis (6%). Nine patients were females and eight were males. The median Cobb angle was 12° at the time of diagnosis and then 17° at the last follow-up. According to the Lenke classification, 11 patients had type 5 curve pattern. During the follow-up period (ranging from 1 to 11 years), scoliosis progression was slow and no patient requiring surgical treatment was detected.

Conclusion: We found that the prevalence of scoliosis increased after pediatric liver transplantation, but we do not have any definite information about the cause. Comparable new studies with more patients are needed to make a definitive conclusion in this regard.

Metrics

Metrics Loading ...

References

Öztürk M, Dağ N, Sığırcı A, Yılmaz S. Evaluation of early and late complications of pediatric liver transplantation with multi-slice computed tomography: a high-volume transplant single-center study. Turk J Gastroenterol. 2021;32(7):586-592.

Mogul DB, Luo X, Bowring MG, et al. Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts. J Pediatr. 2018;196:148-153.e2.

Miloh T, Barton A, Wheeler J, et al. Immunosuppression in pediatric liver transplant recipients: unique aspects. Liver Transpl. 2017;23(2):244-256.

Lee S, Lee S-K. Pediatric liver transplantation in Korea: long-term outcomes and allocations. Korean J Transplant. 2019;33(1):1-5.

Helenius I, Remes V, Tervahartiala P, et al. Spine after solid organ transplantation in childhood: a clinical, radiographic, and magnetic resonance imaging analysis of 40 patients. Spine. 2006;31(18):2130-2136.

Compston J. The skeletal effects of liver transplantation in children. Liver Transpl. 2003;9(4):371-372.

Okajima H, Shigeno C, Inomata Y, et al. Long-term effects of liver transplantation on bone mineral density in children with end-stage liver disease: a 2-year prospective study. Liver Transpl. 2003;9(4):360-364.

Malfair D, Flemming AK, Dvorak MF, et al. Radiographic evaluation of scoliosis: review. AJR Am J Roentgenol. 2010;194(Suppl 3):S8-S22.

Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet. 2008;371(9623):1527-1537.

Shakil H, Iqbal ZA, Al-Ghadir AH. Scoliosis: review of types of curves, etiological theories and conservative treatment. J Back Musculoskelet Rehabil. 2014;27(2):111-115.

Peltonen J, Remes V, Holmberg C, Jalanko H, Helenius I. Surgical correction of spinal deformities after solid organ transplantation in childhood. Eur Spine J. 2006;15(8):1230-1238.

Cobb J. Outline for the study of scoliosis. Instr Course Lect AAOS. 1948;5:261-275.

Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. JBJS. 2001;83(8):1169-1181.

Yılmaz H, Zateri C, Kusvuran Ozkan A, Kayalar G, Berk H. Prevalence of adolescent idiopathic scoliosis in Turkey: an epidemiological study. Spine J. 2020;20(6):947-955.

Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Childs Orthop. 2013;7(1):3-9.

Korkmaz MF, Sevimli R, Selcuk EB, Yılmaz C. Three-dimensional spinal deformity: scoliosis üç boyutlu omurga deformitesi: Skolyoz. Med Sci. 2015;4:1796-1808.

Helenius I, Jalanko H, Remes V, et al. Scoliosis after solid organ transplantation in children and adolescents. Am J Transplant. 2006;6(2):324-330.

Sheikh A, Cundy T, Evans HM. Growth, body composition, and bone density following pediatric liver transplantation. Pediatr Transplant. 2018;22(5):e13201.

Högler W, Baumann U, Kelly D. Endocrine and bone metabolic complications in chronic liver disease and after liver transplantation in children. J Pediatr Gastroenterol Nutr. 2012;54(3):313-321.

Mager D, Al-zaben AS, Robert C, Susan G, Jason Y. Bone mineral density and growth in children having undergone liver transplantation with corticosteroid-free immunosuppressive protocol. J Parenter Enter Nutr. 2017;41(4):632-640.

Faraj W, El Nounou G, Abou Al Naaj A, Nakhoul N, Haydar A, Khalife M. Osteoporosis in pediatric liver transplantation. Prog Transplant. 2016;26(4):389-391.

Soy EA, Kirnap M, Yildirim S, Gokhan M, Mehmet H. Incisional Hernia After Liver Transplant. Exp Clin Transplant Off J Middle East Soc Organ Transplant. 2017;15(Suppl 1):185-189.

Kim H, Kim HS, Moon ES, et al. Scoliosis imaging: what radiologists should know. RadioGraphics. 2010;30(7):1823-1842.

Abul-Kasim K, Karlsson MK, Hasserius R, Ohlin A. Measurement of vertebral rotation in adolescent idiopathic scoliosis with low-dose CT in prone position-method description and reliability analysis. Scoliosis. 2010;5(1):4.

Yazici M, Acaroglu ER, Alanay A, Deviren V, Cila A, Surat A. Measurement of vertebral rotation in standing versus supine position in adolescent idiopathic scoliosis. J Pediatr Orthop. 2001;21(2):252-256.