A recent study (D Ohnemus et al. Liver Transplantation 2020; 26: 45-56, editorial 9-11) examined health-related quality of life (HRQOL) and cognitive functioning approximately 15 years after liver transplantation (LT).
Median age 16 years. Original group was a SPLIT research cohort recruited from 20 centers and then tested at multiple time points; for this study, 8 sites of the original 20 were included. It is noted that patients with serious neurologic injury were excluded. Among an initial group of 108, there were 79 available for potential enrollment. In this group, 65 parent surveys were completed and 61 child surveys.
- For cognitive and school functioning, 60% and 51% of parents reported “poor” functioning, respectively (>1 SD below the health mean). 41% of children rated their cognitive function as poor.
- Adolescents’ self-reported overall HRQOL was similar to that of healthy children; in contrast, parents rated their teenage children as having significantly worse HRQOL than healthy children in all domains.
- The cognitive score in the poor functioning group at the latest time point was lower than at first time point measurement (ages 5-6 years and at least 2 years after LT), “suggesting that difficulties intensified in adolescence for those who have problems in early childhood.”
- Almost half had received special educational services.
The editorial notes that the PedsQL Cognitive Functioning Scale scores used by the investigators were considered subjective. “The more objective PedsPCF scores fell within the normal range.”
My take: This report indicates that a majority of children are likely to have some cognitive deficits and many are likely to have reduced HRQOL following liver transplantation; in addition, if these problems are detected at a younger age, they are likely to persist.
Related blog posts:
- Cognitve Outcomes after Liver Transplantation
- Intellectual Disability in Pediatric Liver Transplantation
- Outcomes of Liver Transplantation in Small Infants
- Alive and well? 10 years after liver transplantation