RE: Spinal Cord Ischemia Post-pancreas Transplant.

Abstract

We read the article, “Spinal cord ischemia in pancreas transplantation: the UK experience,” by Phillips et al.1 In it, they reported 6 cases of spinal cord ischemia following pancreas transplantation since 2002 after performing a survey of all UK pancreas transplant units. Therefore, we attempted to determine the incidence of this complication in the United States using the Healthcare Cost and Utilization Project National Inpatient Sample, the largest database for hospital discharge. We identified 2346 pancreas transplant patients with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 52.8* (Transplant of Pancreas) between the years 2005–2014. Of the 1440 results (61.4%) that included kidney transplant, 0 contained a diagnosis of spinal cord ischemia (336.1-vascular myelopathies). Further investigation into patients receiving an MRI of the spinal cord with the relevant ICD 9 procedure code (88.93) again resulted in 0. This discrepancy suggests large databases may be unable to capture rare conditions. Therefore, we must emphasize the application of proper coding to maximize transparency.