Cochlear implantation of solid organ transplant patients receiving immunosuppressive therapy

To evaluate the incidence of infectious complications and healing problems in cochlear implant (CI) patients receiving immunosuppressive therapy following solid organ transplant.

IRB-approved retrospective chart review of implanted patients.

Tertiary care children's hospital.

Seven patients of the more than 1000 implanted during the time period between 1991 and 2014 underwent cochlear implantation while on immunosuppressive therapy after having received a solid organ transplant. Their charts were reviewed for demographic and medical information pre- and post-implantation. The 4 males and 3 females ranged in age at CI from 2.4 to 18.8 years, with a mean of 9.0 years. Postimplant follow-up averaged 3.9 years (range: 0.1-13.1). Main outcome measures were occurrence of wound healing, infectious complications, whether open-set word recognition was achieved, and communication mode(s).

No wound infections or delayed healing, mastoiditis, or bacterial meningitis occurred after cochlear implantation. All seven patients had received at least one pneumococcal vaccination prior to implantation. Five of 6 (83%) developed open-set speech perception, of whom 4 (67%) use only oral communication.

In our series of patients receiving immunosuppressive therapy following solid organ transplantation, none developed wound healing or infectious complications after cochlear implantation. History of solid organ transplantation alone should not be a contraindication to cochlear implant candidacy which would deprive the child of the potential benefits of hearing, including language development.