Delayed transplantation may affect intellectual ability in children

作者：Lee Jiwon M; Jung Yeon Kyung; Bae Jeong Hoon; Yoon Sun Ah; Kim Ju Hee; Choi YoungRok; Kim Hyeyoung; Lee Kwang Woong; Ahn Hye Young; Kim Jae Won; Shin Min Sup; Suh Kyung Suk; Ha Il Soo; Cheong Hae Il; Kang Hee Gyung; Yi Nam Joon^*

来源：Pediatrics International, 2017, 59(10): 1080-1086.

DOI：10.1111/ped.13369

• attention-deficit-hyperactivity disorder
• cognitive impairment
• intelligence
• pediatrics
• transplantation

BackgroundDecline in neurocognitive function is a reported complication in children with chronic illness. Concerns have been increasing that exposure to a major surgery or trauma may negatively affect cognitive performance in children. This study evaluated cognitive function in 43 Korean children who received organ transplantation (Tx), and sought to identify associated clinical factors.
MethodsPediatric recipients of kidney (KT) or liver Tx (LT) from 1999 to 2011 were recruited for cognitive tests. Cognitive function was evaluated using intelligence quotient (IQ), social quotient (SQ), and Continuous Performance Test using Advanced Test for Attention scores, which reflect attention ability. Intellectual delay was graded as intellectual disability (ID; IQ <70) or low intelligence (LI; IQ<85). Diagnosis for attention-deficit-hyperactivity disorder (ADHD) was made by pediatric psychiatrists.
ResultsThe subjects consisted of 43 pediatric recipients of 28 LT and 15 KT. There were 20 boys (46.5%). Median age was 3.1years (range, 0.5-15.3years) at Tx. Median age at cognitive evaluation was 12.9years (range, 3.4-18.4years). Median pre-Tx duration of illness was 1.6years (range, 0-13.5years). The prevalence of ID, LI, and ADHD was 11.6%, 32.5%, and 32.5%, respectively. On multivariate analysis, longer pre-Tx duration of illness was a significant factor for LI (OR, 1.263; 95%CI: 1.033-1.544, P=0.023).
ConclusionLonger pre-Tx duration may negatively affect intellectual ability in Korean children. Pre-Tx duration was more significant than the age at Tx or total disease duration per se. Early Tx may be beneficial for cognitive function in children.

• 出版日期2017-10