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Medical Science Monitor Basic Research


eISSN: 2329-0358

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

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

DOI: 10.12659/AOT.914164

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

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