Cognitive Outcomes after Liver Transplantation

An important measure of liver transplantation (LT) is cognitive/academic outcomes. Previous studies have indicated increased intellectual deficits but were not optimally-designed.  A recent study (J Pediatr 2014; 165: 65-72) overcomes many of the limitations of previous studies.

Study design: Prospective, multicenter longitudinal cohort of neurocognitive functioning after pediatric liver transplantation.  144 participants, ≥2 years after liver transplantation -recruited through Studies of Pediatric Liver Transplantation (SPLIT).  Tested with multiple cognitive test at two separate time points.

Key findings:

  • At the time 2, 29% had full scale IQ (FSIQ) between 71-85 (compared to 14% expected); 7% had FSIQ <71 (compared with 2% expected)
  • 42% received special education.
  • Pretransplant markers of nutritional status and operative complications predicted intellectual outcome
  • Having a primary care provider with a college education was a protective factor.

One limitation of the study was that only 55% of those approached to participate were enrolled; however, the authors noted similar demographics between those who enrolled and those who did not.