Lisa G Sorensen1, Katie Neighbors2, Karen Martz3, Frank Zelko4, John C Bucuvalas5, Estella M Alonso2. 1. Child & Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. Electronic address: Lsorensen@luriechildrens.org. 2. Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. 3. The EMMES Corporation, Rockville, MD. 4. Child & Adolescent Psychiatry, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. 5. Pediatric Liver Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Abstract
OBJECTIVE: To determine the evolution of cognitive and academic deficits and risk factors in children after liver transplantation. STUDY DESIGN: Patients ≥2 years after liver transplantation were recruited through Studies of Pediatric Liver Transplantation. Participants age 5-6 years at Time 1 completed the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition, Wide Range Achievement Test, 4th edition, and Behavior Rating Inventory of Executive Function (BRIEF). Participants were retested at age 7-9 years, Time 2 (T2), by use of the Wechsler Intelligence Scales for Children, 4th edition, Wide Range Achievement Test, 4th edition, and BRIEF. Medical and demographic variables significant at P ≤ .10 in univariate analysis were fitted to repeated measures modeling predicting Full Scale IQ (FSIQ). RESULTS: Of 144 patients tested at time 1, 93 (65%) completed T2; returning patients did not differ on medical or demographic variables. At T2, more participants than expected had below-average FSIQ, Verbal Comprehension, Working Memory, and Math Computation, as well as increased executive deficits on teacher BRIEF. Processing Speed approached significance. At T2, 29% (14% expected) had FSIQ = 71-85, and 7% (2% expected) had FSIQ ≤70 (P = .0001). A total of 42% received special education. Paired comparisons revealed that, over time, cognitive and math deficits persisted; only reading improved. Modeling identified household status (P < .002), parent education (P < .01), weight z-score at liver transplantation (P < .03), and transfusion volume during liver transplantation (P < .0001) as predictors of FSIQ. CONCLUSIONS: More young liver transplantation recipients than expected are at increased risk for lasting cognitive and academic deficits. Pretransplant markers of nutritional status and operative complications predicted intellectual outcome.
OBJECTIVE: To determine the evolution of cognitive and academic deficits and risk factors in children after liver transplantation. STUDY DESIGN:Patients ≥2 years after liver transplantation were recruited through Studies of Pediatric Liver Transplantation. Participants age 5-6 years at Time 1 completed the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition, Wide Range Achievement Test, 4th edition, and Behavior Rating Inventory of Executive Function (BRIEF). Participants were retested at age 7-9 years, Time 2 (T2), by use of the Wechsler Intelligence Scales for Children, 4th edition, Wide Range Achievement Test, 4th edition, and BRIEF. Medical and demographic variables significant at P ≤ .10 in univariate analysis were fitted to repeated measures modeling predicting Full Scale IQ (FSIQ). RESULTS: Of 144 patients tested at time 1, 93 (65%) completed T2; returning patients did not differ on medical or demographic variables. At T2, more participants than expected had below-average FSIQ, Verbal Comprehension, Working Memory, and Math Computation, as well as increased executive deficits on teacher BRIEF. Processing Speed approached significance. At T2, 29% (14% expected) had FSIQ = 71-85, and 7% (2% expected) had FSIQ ≤70 (P = .0001). A total of 42% received special education. Paired comparisons revealed that, over time, cognitive and math deficits persisted; only reading improved. Modeling identified household status (P < .002), parent education (P < .01), weight z-score at liver transplantation (P < .03), and transfusion volume during liver transplantation (P < .0001) as predictors of FSIQ. CONCLUSIONS: More young liver transplantation recipients than expected are at increased risk for lasting cognitive and academic deficits. Pretransplant markers of nutritional status and operative complications predicted intellectual outcome.
Authors: Janina R Galler; Cyralene P Bryce; Miriam L Zichlin; Garrett Fitzmaurice; G David Eaglesfield; Deborah P Waber Journal: J Nutr Date: 2012-02-29 Impact factor: 4.798
Authors: Cara L Mack; Frank A Zelko; Joan Lokar; Riccardo Superina; Estella M Alonso; Andres T Blei; Peter F Whitington Journal: Pediatrics Date: 2006-02-15 Impact factor: 7.124
Authors: Stacey V Konidis; Alexander Hrycko; Scott Nightingale; Eberhard Renner; Leslie Lilly; George Therapondos; Ann Fu; Yaron Avitzur; Vicky Lee Ng Journal: Paediatr Child Health Date: 2015-05 Impact factor: 2.253
Authors: Anna Gold; Alaine Rogers; Elizabeth Cruchley; Stephanie Rankin; Arpita Parmar; Binita M Kamath; Yaron Avitzur; Vicky Lee Ng Journal: Can J Gastroenterol Hepatol Date: 2017-01-17
Authors: Nelly Mauras; Bruce Buckingham; Neil H White; Eva Tsalikian; Stuart A Weinzimer; Booil Jo; Allison Cato; Larry A Fox; Tandy Aye; Ana Maria Arbelaez; Tamara Hershey; Michael Tansey; William Tamborlane; Lara C Foland-Ross; Hanyang Shen; Kimberly Englert; Paul Mazaika; Matthew Marzelli; Allan L Reiss Journal: Diabetes Care Date: 2021-02-10 Impact factor: 19.112
Authors: Stephanie Barbara Schatz; Christoph Jüngst; Verena Keitel-Anselmo; Ralf Kubitz; Christina Becker; Patrick Gerner; Eva-Doreen Pfister; Imeke Goldschmidt; Norman Junge; Daniel Wenning; Stephan Gehring; Stefan Arens; Dirk Bretschneider; Dirk Grothues; Guido Engelmann; Frank Lammert; Ulrich Baumann Journal: Hepatol Commun Date: 2018-03-22