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Ying Sun, Lili Jia, Hongli Yu, Min Zhu, Mingwei Sheng, Wenli Yu
(Department of Anesthesiology, Tianjin First Center Hospital, Tianjin, China (mainland))
Ann Transplant 2019; 24:446-453
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