American Journal of Transplantation

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Vol 17 (13 Issues in 2017)
Edited by: Allan D. Kirk
Print ISSN: 1600-6135 Online ISSN: 1600-6143
Impact Factor: 6.165

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Medicine & Healthcare, Wiley-Blackwell

November 18, 2013

Pediatric Liver Transplant Patients May Face Cognitive Problems as They Age

Young children who undergo liver transplantations often experience cognitive deficits during their school-aged years. That’s the conclusion of a new study published in the American Journal of Transplantation. The findings point to the need for careful monitoring of these patients as well as for additional research into possible treatments.

How liver transplantation might affect a child’s cognitive development is poorly understood. Tanja Kaller and Karl-Heinz Schulz, MD PhD, both of the University Medical Center Hamburg-Eppendorf in Germany, led a team that examined the prevalence of long-term cognitive impairment in 64 pediatric liver transplant patients, with a median age of 12 months at the time of transplantation. All patients were school-aged when they were tested, and their test results were compared with age- and sex-matched children without chronic health conditions.

In cognitive tests, children who received a liver transplant showed a significantly worse total intelligence, or IQ, score. In three of four underlying cognitive domains (verbal comprehension, perceptual reasoning, and processing speed), their scores were significantly lower. Twice as many transplant recipients showed serious cognitive delays compared with other children in the study (9.4 percent vs 4.7 percent). Children with genetic-metabolic liver diseases—some of which are known to affect the brain—exhibited the lowest IQ-scores. The researchers found that shorter height at the time of transplantation was the most relevant predictor of post-transplant cognitive problems, a finding that may be related to the children’s preoperative nutritional state.