In:
Pediatric Transplantation, Wiley, Vol. 17, No. 7 ( 2013-11), p. 621-630
Abstract:
This prospective inception cohort study determines kindergarten‐entry neurocognitive abilities and explores their predictors following liver transplantation at age 〈 3 yr. Of 52 children transplanted (1999–2008), 33 (89.2%) of 37 eligible survivors had psychological assessment at age 54.7 (8.4) months: 21 with biliary atresia, seven chronic cholestasis, and five acute liver failure. Neurocognitive scores (mean [s.d.], 100 [15] ) as tested by a pediatric‐experienced psychologist did not differ in relation to age group at transplant (≤12 months and 〉 12 months): FSIQ , 93.9 (17.1); verbal ( VIQ ), 95.3 (16.5); performance ( PIQ ), 94.3 (18.1); and VMI , 90.5 (15.9), with 〉 70% having scores ≥85, average or above. Adverse predictors from the pretransplant, transplant, and post‐transplant (30 days) periods using univariate linear regressions for FSIQ were post‐transplant use of inotropes, p = 0.029; longer transplant warm ischemia time, p = 0.035; and post‐transplant highest serum creatinine, (p = 0.04). For PIQ , they were pretransplant encephalopathy, p = 0.027; post‐transplant highest serum creatinine, p = 0.034; and post‐transplant inotrope use, p = 0.037. For VMI , they were number of post‐transplant infections, p = 0.019; post‐transplant highest serum creatinine, p = 0.025; and lower family socioeconomic index, p = 0.039. Changes in care addressing modifiable predictors, including reducing acute post‐transplant illness, pretransplant encephalopathy, transplant warm ischemia times, and preserving renal function, may improve neurocognitive outcomes.
Type of Medium:
Online Resource
ISSN:
1397-3142
,
1399-3046
DOI:
10.1111/petr.2013.17.issue-7
Language:
English
Publisher:
Wiley
Publication Date:
2013
detail.hit.zdb_id:
2008614-3
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