Outcomes of head and neck surgery in patients with a history of solid organ transplantation

Abstract

Objectives/Hypothesis Examine the prevalence and outcomes of head and neck surgeries in patients with a history of organ transplantation. Study Design A retrospective cross‐sectional analysis utilizing the Nationwide Readmissions Database, 2010 to 2014. Methods The study population included adults patients who underwent head and neck surgeries. Patients with a reported history of solid organ transplantation were compared to patients with no such history. Results The study population included 322 transplant patients (76.4% kidney, 8.7% liver, 8.4% heart, 3.0% kidney/pancreas, 2.3% lung, 0.9% kidney/liver, 0.4% pancreas) and 120,401 controls who underwent comparable procedures. Main surgeries that were performed in cases included 37.8% parathyroid, 17.7% thyroid, 11.2% major salivary gland, 10.6% major mouth/tonsil, and 9.6% major nose/paranasal sinuses. Encountering transplant patients in otolaryngology practice has been increasing annually by three patients for every 10,000 procedures performed in the United States. There was no difference in the overall postoperative complications risk (12.5% vs. 10.1%, P = .26); however, cases had a higher risk of acute renal failure (5.4% vs. 1.1%, P < .001) and shock state (0.3% vs. 0.02%, P < .001). Readmission risk was higher for cases (6.8% vs. 3.4%, P = .003). There was no reported in‐hospital mortality among cases. Conclusions Transplant patients are increasingly encountered in otolaryngology practices. The most common transplanted organ is kidney, and the most commonly performed procedure is parathyroidectomy. Level of Evidence NA Laryngoscope, 130:E89–E97, 2020

Otorhinolaryngological dysfunctions induced by chronic kidney disease in pre- and post-transplant stages

“…On the other hand, the incidences of HPV-related cancers (laryngeal and oropharyngeal cancers) and EBV-related cancers (nasopharyngeal cancer) were similar in HIV-infected patients, and in organ recipients in this study [36]. Various researches presented co-carcinogenic influence of HPV and EBV on oncogenesis in oral cavity, oro-and nasopharynx, and larynx [32,34,35]. Among head and neck cancers, especially high incidence of oral and oropharyngeal cancers after solid organ transplantation was observed [5,37].…”

“…This study analyzing the 10 years follow-up period reported that 80% of all head and neck cancers were of cutaneous type [34]. The significant increase in the prevalence of several head and neck tumors after kidney transplant, namely oral, salivary and non-melanoma skin cancer was found by Al-Qurayshi et al [35]. Nevertheless, it was reported that in otolaryngology practice, RTRs were predisposed to develop head and neck squamous cell carcinoma (HNSSC) both related and unrelated to a latent viral infection [35].…”

“…The significant increase in the prevalence of several head and neck tumors after kidney transplant, namely oral, salivary and non-melanoma skin cancer was found by Al-Qurayshi et al [35]. Nevertheless, it was reported that in otolaryngology practice, RTRs were predisposed to develop head and neck squamous cell carcinoma (HNSSC) both related and unrelated to a latent viral infection [35]. High prevalence of carcinogenesis induced by oncogenic viruses was also observed for patients infected by human immunodeficiency virus (HIV) [36].…”

Revision Total Hip Arthroplasty in Solid Organ Transplant Patients: A Propensity Score-Matched Cohort Study for Aseptic and Infected Revisions

“…PJI is the most feared complication following arthroplasty in SOT patients given the hypothesized higher risk posed by the use of chronic immunosuppressive medications in these patients. However, across surgical specialties, in comparative studies of elective surgical procedures adjusting for underlying medical comorbidity, SOT patients have similar rates of post-operative infections and wound complications [ 22 , 23 ]. Prior studies on complications following TJA in SOT patients have also not conclusively shown an increased risk [ 5 , [24] , [25] , [26] , [27] ].…”

Prevalence and mortality of cardiovascular events in patients with hyperthyroidism: a nationwide cohort study in the United States

“…This is a retrospective cohort study based on the Nationwide Readmission Database (NRD) from 2010 to 2017. NRD is part of the Healthcare Cost and Utilization Project (HCUP) covers 57.8% of the entire United States population, and is used to assess the cost and quality of healthcare services (8). The NRD database contains the following information: sociodemographic information, data about the diagnosis and procedures at hospitalization admission based on the International Classification of Diagnosis Ninth and Tenth Revision (ICD-9 and ICD-10) codes, and in-patient outcomes (Table S1).…”