Cognitive outcomes in paediatric liver transplant survivors

Tulpesh Patel, Joel B. Talcott, Sue V. Beath, Jacqueline C. Blyth, Jaswant Sira, Jemma Mears, Gareth Griffiths, Indra van Mourik, Deirdre Kelly

Research output: Contribution to journalMeeting abstract

Abstract

PURPOSE: To investigate the impact of liver disease on cognitive ability in children with liver disease in the context of covariates such as the age of onset and transplant (Tx) intervention.
METHOD: This cross-sectional study used standard Wechsler psychometric assessment batteries to evaluate neuropsychological function (Full-scale IQ and Information Processing Speed (IPS)). We studied 23 children wish liver diseases, of whom 13 had indergone liver Tx, and compared their performance to 9 healthy age-matching controls, 17 patients had cholestatic liver disease from birth (early onset liver disease (EOLD); pre-Tx n=10, post-Tx n=7), 6 were well until they developed fulminant liver failure after3 year of age (late onset liver disease (LOLD); post-Tx n=6.
RESULTS: Chronic liver disease bad significant negative effect on cognitive
development, with age at the onset of disease an important moderator of this effect. Significant difference in IPS were observed between the EOLD, post-Tx group (IPS=81.6) and controls (mean IPS=104.7) p= .017; (d)=1.36), with 31% of the variance in IPS accoutered for by EOLD coupled with transplantation. Differences in IPS between the EOLD post-Tx patients and EOLD pre-Tx patients (mean IPS=91.7) approached statistical significance (p=.06; effect size (d)=1.26). LOLD (fulminant liver failure) post-Tx patients (mean IPS=102.5) performed no differently to controls on any psychometric measures.
CONCLUSION: EOLD has a significant impact on cognitive outcomes, possibly
through the disruption of early underdevelopment processes. Survivors of fulminant liver failure however, have performances similar to that of the healthy controls suggesting that the transplant procedure itself did not affect cognitive outcome. Enrolling patients in a large-scale, longitudinal study would help illuminate the extent and persistence of the cognitive deficits observed in paediatric liver disease.
Original languageEnglish
Article number93
Pages (from-to)65
Number of pages1
JournalPediatric Transplantation
Volume15
Issue numberS1
DOIs
Publication statusPublished - 1 Aug 2011
Event6th Congress of the International Pediatric Transplant Association - Montreal, Canada
Duration: 25 Jun 201128 Jun 2011

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Survivors
Liver Diseases
Pediatrics
Transplants
Liver
Automatic Data Processing
Acute Liver Failure
Age of Onset
Psychometrics
Aptitude
Longitudinal Studies
Chronic Disease
Cross-Sectional Studies
Transplantation
Parturition

Bibliographical note

6th Congress of the International Pediatric Transplant Association Abstracts

Cite this

Patel, T., Talcott, J. B., Beath, S. V., Blyth, J. C., Sira, J., Mears, J., ... Kelly, D. (2011). Cognitive outcomes in paediatric liver transplant survivors. Pediatric Transplantation , 15(S1), 65. [93]. https://doi.org/10.1111/petr.2011.15.issue-s1
Patel, Tulpesh ; Talcott, Joel B. ; Beath, Sue V. ; Blyth, Jacqueline C. ; Sira, Jaswant ; Mears, Jemma ; Griffiths, Gareth ; van Mourik, Indra ; Kelly, Deirdre. / Cognitive outcomes in paediatric liver transplant survivors. In: Pediatric Transplantation . 2011 ; Vol. 15, No. S1. pp. 65.
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abstract = "PURPOSE: To investigate the impact of liver disease on cognitive ability in children with liver disease in the context of covariates such as the age of onset and transplant (Tx) intervention.METHOD: This cross-sectional study used standard Wechsler psychometric assessment batteries to evaluate neuropsychological function (Full-scale IQ and Information Processing Speed (IPS)). We studied 23 children wish liver diseases, of whom 13 had indergone liver Tx, and compared their performance to 9 healthy age-matching controls, 17 patients had cholestatic liver disease from birth (early onset liver disease (EOLD); pre-Tx n=10, post-Tx n=7), 6 were well until they developed fulminant liver failure after3 year of age (late onset liver disease (LOLD); post-Tx n=6.RESULTS: Chronic liver disease bad significant negative effect on cognitivedevelopment, with age at the onset of disease an important moderator of this effect. Significant difference in IPS were observed between the EOLD, post-Tx group (IPS=81.6) and controls (mean IPS=104.7) p= .017; (d)=1.36), with 31{\%} of the variance in IPS accoutered for by EOLD coupled with transplantation. Differences in IPS between the EOLD post-Tx patients and EOLD pre-Tx patients (mean IPS=91.7) approached statistical significance (p=.06; effect size (d)=1.26). LOLD (fulminant liver failure) post-Tx patients (mean IPS=102.5) performed no differently to controls on any psychometric measures.CONCLUSION: EOLD has a significant impact on cognitive outcomes, possiblythrough the disruption of early underdevelopment processes. Survivors of fulminant liver failure however, have performances similar to that of the healthy controls suggesting that the transplant procedure itself did not affect cognitive outcome. Enrolling patients in a large-scale, longitudinal study would help illuminate the extent and persistence of the cognitive deficits observed in paediatric liver disease.",
author = "Tulpesh Patel and Talcott, {Joel B.} and Beath, {Sue V.} and Blyth, {Jacqueline C.} and Jaswant Sira and Jemma Mears and Gareth Griffiths and {van Mourik}, Indra and Deirdre Kelly",
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Patel, T, Talcott, JB, Beath, SV, Blyth, JC, Sira, J, Mears, J, Griffiths, G, van Mourik, I & Kelly, D 2011, 'Cognitive outcomes in paediatric liver transplant survivors', Pediatric Transplantation , vol. 15, no. S1, 93, pp. 65. https://doi.org/10.1111/petr.2011.15.issue-s1

Cognitive outcomes in paediatric liver transplant survivors. / Patel, Tulpesh; Talcott, Joel B.; Beath, Sue V.; Blyth, Jacqueline C.; Sira, Jaswant; Mears, Jemma; Griffiths, Gareth; van Mourik, Indra; Kelly, Deirdre.

In: Pediatric Transplantation , Vol. 15, No. S1, 93, 01.08.2011, p. 65.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - Cognitive outcomes in paediatric liver transplant survivors

AU - Patel, Tulpesh

AU - Talcott, Joel B.

AU - Beath, Sue V.

AU - Blyth, Jacqueline C.

AU - Sira, Jaswant

AU - Mears, Jemma

AU - Griffiths, Gareth

AU - van Mourik, Indra

AU - Kelly, Deirdre

N1 - 6th Congress of the International Pediatric Transplant Association Abstracts

PY - 2011/8/1

Y1 - 2011/8/1

N2 - PURPOSE: To investigate the impact of liver disease on cognitive ability in children with liver disease in the context of covariates such as the age of onset and transplant (Tx) intervention.METHOD: This cross-sectional study used standard Wechsler psychometric assessment batteries to evaluate neuropsychological function (Full-scale IQ and Information Processing Speed (IPS)). We studied 23 children wish liver diseases, of whom 13 had indergone liver Tx, and compared their performance to 9 healthy age-matching controls, 17 patients had cholestatic liver disease from birth (early onset liver disease (EOLD); pre-Tx n=10, post-Tx n=7), 6 were well until they developed fulminant liver failure after3 year of age (late onset liver disease (LOLD); post-Tx n=6.RESULTS: Chronic liver disease bad significant negative effect on cognitivedevelopment, with age at the onset of disease an important moderator of this effect. Significant difference in IPS were observed between the EOLD, post-Tx group (IPS=81.6) and controls (mean IPS=104.7) p= .017; (d)=1.36), with 31% of the variance in IPS accoutered for by EOLD coupled with transplantation. Differences in IPS between the EOLD post-Tx patients and EOLD pre-Tx patients (mean IPS=91.7) approached statistical significance (p=.06; effect size (d)=1.26). LOLD (fulminant liver failure) post-Tx patients (mean IPS=102.5) performed no differently to controls on any psychometric measures.CONCLUSION: EOLD has a significant impact on cognitive outcomes, possiblythrough the disruption of early underdevelopment processes. Survivors of fulminant liver failure however, have performances similar to that of the healthy controls suggesting that the transplant procedure itself did not affect cognitive outcome. Enrolling patients in a large-scale, longitudinal study would help illuminate the extent and persistence of the cognitive deficits observed in paediatric liver disease.

AB - PURPOSE: To investigate the impact of liver disease on cognitive ability in children with liver disease in the context of covariates such as the age of onset and transplant (Tx) intervention.METHOD: This cross-sectional study used standard Wechsler psychometric assessment batteries to evaluate neuropsychological function (Full-scale IQ and Information Processing Speed (IPS)). We studied 23 children wish liver diseases, of whom 13 had indergone liver Tx, and compared their performance to 9 healthy age-matching controls, 17 patients had cholestatic liver disease from birth (early onset liver disease (EOLD); pre-Tx n=10, post-Tx n=7), 6 were well until they developed fulminant liver failure after3 year of age (late onset liver disease (LOLD); post-Tx n=6.RESULTS: Chronic liver disease bad significant negative effect on cognitivedevelopment, with age at the onset of disease an important moderator of this effect. Significant difference in IPS were observed between the EOLD, post-Tx group (IPS=81.6) and controls (mean IPS=104.7) p= .017; (d)=1.36), with 31% of the variance in IPS accoutered for by EOLD coupled with transplantation. Differences in IPS between the EOLD post-Tx patients and EOLD pre-Tx patients (mean IPS=91.7) approached statistical significance (p=.06; effect size (d)=1.26). LOLD (fulminant liver failure) post-Tx patients (mean IPS=102.5) performed no differently to controls on any psychometric measures.CONCLUSION: EOLD has a significant impact on cognitive outcomes, possiblythrough the disruption of early underdevelopment processes. Survivors of fulminant liver failure however, have performances similar to that of the healthy controls suggesting that the transplant procedure itself did not affect cognitive outcome. Enrolling patients in a large-scale, longitudinal study would help illuminate the extent and persistence of the cognitive deficits observed in paediatric liver disease.

UR - http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3046.2011.01525.x/abstract

U2 - 10.1111/petr.2011.15.issue-s1

DO - 10.1111/petr.2011.15.issue-s1

M3 - Meeting abstract

VL - 15

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Patel T, Talcott JB, Beath SV, Blyth JC, Sira J, Mears J et al. Cognitive outcomes in paediatric liver transplant survivors. Pediatric Transplantation . 2011 Aug 1;15(S1):65. 93. https://doi.org/10.1111/petr.2011.15.issue-s1