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02 August 2019 : Original article  

The Effect of Pediatric Living Donor Liver Transplantation on Neurocognitive Outcomes in Children

Ying Sun1ABC, Lili Jia1BDE, Hongli Yu1CF, Min Zhu1CEF, Mingwei Sheng1BDEF, Wenli Yu1AG*

DOI: 10.12659/AOT.914164

Ann Transplant 2019; 24:446-453

Abstract

BACKGROUND: Neurocognitive dysfunction commonly occurs after solid organ transplantation and affects 15–30% of liver transplant recipients. The aim of this study was to evaluate the neurocognitive changes pre- and post-operation and the relative factors affecting those changes.

MATERIAL AND METHODS: Children with biliary atresia who underwent pediatric living donor-related liver transplantation before the age of 2 years were given Bayley Scale of Infant Development-II test (BSID-II), including Mental Development Index (MDI) and Psychomotor Development Index (PDI) the week before and again half a year after transplantation to assess the effect of transplantation on neurocognition. According to the test outcome, the children were divided into a normal group and an abnormal group. The association of clinical data with neurocognitive development between the 2 groups was analyzed by logistic regression analysis.

RESULTS: There was a certain degree of improvement in neurocognition half a year after surgery compared with preoperative. The BSID-II subscales were significantly lower than expected before and after transplantation. Preoperative blood ammonia and bilirubin levels were independent risk factors for MDI half a year after transplantation, and preoperative albumin and bilirubin levels were risk factors for PDI.

CONCLUSIONS: Liver transplantation clearly improves children’s neurocognitive function. The postoperative neurocognition is closely related to pre-operation nutritional development.

Keywords: Cognition, Liver Transplantation, Pediatrics, biliary atresia, Child, Preschool, Infant, Living Donors, Neuropsychological Tests, Postoperative Complications

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358