Influence of olfactory ensheathing cell transplantation on body temperature of patients with old spinal cord injury

BACKGROUND： Olfactory ensheathing cell transplantation may transiently raise body temperature in some patients with old spinal cord injury. OBJECTIVE： To analyze the influence of olfactory ensheathing cell transplantation on body temperature changes and neurological functional recovery in patients with old spinal cord injury. DESIGN, TIME AND SETTING： A non-randomized self-controlled study, which was performed in the wards of the Department of Surgery, Taian Disabled Soldier＇s Hospital of Shandong Province, between June 2004 and July 2007. PARTICIPANTS： 119 inpatients with old spinal cord injury were selected for this study, including 110 males and 9 females, aged 5-58 years. METHODS： The olfactory bulb of an aborted fetus was digested into a single-cell suspension of olfactory ensheathing cells, which were then cultured and purified for 7-10 days, and once again made into a single-cell suspension. The olfactory ensheathing cell suspension was then transplanted in the juncture of the normal spinal cord and the abnormal spinal cord under surgical microscopy, with 1 × 10^6 cells per target point, with 2-5 target points in total. According to changes in postoperative temperature, 119 patients were divided into three groups： body temperature （T） ≤ 38.0 ℃ （n = 40）, 38.0 ℃ 〈 T ≤ 39.0 ℃ （n = 67）, T 〉 39.0℃ （n = 12）. In particular, T 〉 38℃ （n = 79） patients were divided into two subgroups according to duration of fever： ≤3 days （n = 61） and ≥ 4 days （n = 18）. MAIN OUTCOME MEASURES： Neurological function was evaluated by the American Spinal Cord Injury （ASIA） scale set by American Spinal Cord Injury Academy in 2000 one day prior to transplantation and one or two months after transplantation. RESULTS： 119 patients were included in the final analysis, without any loss. Following olfactory ensheathing cell transplantation, body temperatures changed as follows： T ≤ 38.0 ℃ （n = 40, 33.6%）, 38.0 ℃ 〈 T ≤ 39.0 ℃ （n = 67, 56.3%）, 〉 39.0 ℃ （n = 12, 10.1%）. Moreover, among 79 patients （T 〉 38 ℃）, the febrile time of 61 cases （77%） was ≤ 3 days, and that of 18 cases （23%） ≥ 4 days. ASIA scores increased after olfactory ensheathing cell transplantation （P 〈 0.05-0.01）. CONCLUSION： Moderate febricity frequently occurred in patients that received olfactory ensheathing cell transplantation, and febrile time lasted for more than 3 days. Additionally, olfactory ensheathing cell transplantation can remarkably improve neurological functional recovery.