Transplant and risk of Parkinson disease

Authors

Jessica Fan, Washington University School of Medicine, Department of Neurology, 660 S. Euclid Ave, Campus Box 8111, St. Louis, 63110, MO, USA. Electronic address: jessica.fan@uphs.upenn.edu.
Susan Searles Nielsen, Washington University School of Medicine, Department of Neurology, 660 S. Euclid Ave, Campus Box 8111, St. Louis, 63110, MO, USA. Electronic address: searles-nielsens@wustl.edu.
Irene M. Faust, Washington University School of Medicine, Department of Neurology, 660 S. Euclid Ave, Campus Box 8111, St. Louis, 63110, MO, USA. Electronic address: faustim@wustl.edu.
Brad A. Racette, Washington University School of Medicine, Department of Neurology, 660 S. Euclid Ave, Campus Box 8111, St. Louis, 63110, MO, USA; University of the Witwatersrand, School of Public Health, Faculty of Health Sciences, 27 Saint Andrews Road, Johannesburg, South Africa. Electronic address: racetteb@wustl.edu.

Document Type

Article

Abstract

INTRODUCTION: The pathophysiology of Parkinson's disease (PD) remains unclear, but growing evidence supports a role of neuroinflammation. The purpose of this study was to investigate the association between tissue transplantation and PD risk, given the importance of immunosuppressants in post-transplant management. METHODS: We performed a case-control study among Medicare beneficiaries age 66-90 using claims from 2004 to 2009. We used International Classification of Diseases, Ninth Edition (ICD-9) and Current Procedural Terminology (CPT) codes to identify PD (89,790 incident cases, 118,095 population-based controls) and history of tissue transplant (kidney, heart, liver, lung, and bone marrow). We investigated risk of PD in relation to tissue transplant in logistic regression models, adjusting for age, sex, race, smoking, and overall use of medical care. RESULTS: Beneficiaries who had received a tissue transplant at least five years prior to PD diagnosis or reference had a lower risk of PD (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.53, 0.75) than those without tissue transplant. This inverse association was observed for kidney (OR 0.63, 95% CI 0.47, 0.84), heart (OR 0.58, 95% CI 0.40, 0.83), lung (OR 0.41, 95% CI 0.21, 0.77), and bone marrow (OR 0.57, 95% 0.38, 0.85) transplants. Associations were attenuated, but remained, following adjustment for indications for the respective type of transplant. Liver transplant was not associated with PD risk. CONCLUSIONS: Patients undergoing tissue transplant may have a lower risk of developing PD than the general population. Further studies are needed to determine if this association is causal and if immunosuppressants mediate this association.

Medical Subject Headings

Aged; Aged, 80 and over; Bone Marrow Transplantation (statistics & numerical data); Case-Control Studies; Female; Humans; Kidney Transplantation (statistics & numerical data); Liver Transplantation (statistics & numerical data); Lung Transplantation (statistics & numerical data); Male; Medicare (statistics & numerical data); Parkinson Disease (epidemiology); Risk; United States (epidemiology)

Publication Date

6-1-2019

Publication Title

Parkinsonism & related disorders

E-ISSN

1873-5126

Volume

63

First Page

149

Last Page

155

PubMed ID

30827837

Digital Object Identifier (DOI)

10.1016/j.parkreldis.2019.02.013

Recommended Citation

Fan, Jessica; Searles Nielsen, Susan; Faust, Irene M.; and Racette, Brad A., "Transplant and risk of Parkinson disease" (2019). Neurology. 1190.
https://scholar.barrowneuro.org/neurology/1190