Delayed transplantation may affect intellectual ability in children

Background Decline 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 impact cognitive performance in children. This study has evaluated cognitive function in 43 Korean children who received organ transplantation, and sought to identify associated clinical factors. Methods Pediatric recipients of kidney (KT) or liver transplantation (LT) from years 1999 to 2011 were recruited for cognitive tests. Cognitive function was evaluated by Intelligent Quotient (IQ), Social Quotient (SQ), and Continuous Performance Test using Advanced Test for Attention (ATA) scores which reflect the attention ability. Intellectual delay was graded as intellectual disability (ID, IQ <70) or low intelligence (LI, IQ<85). Diagnosis for Attention Deficit Hyperactivity Disease (ADHD) was made by pediatric psychiatrists. Results 43 pediatric recipients with 28 LT and 15 KT were included. There were 20 boys (46.5%). Median age was 3.1 (range: 0.5-15.3) years at transplantation (Tx). The median age at the cognitive evaluation was 12.9 [3.4-18.4] years. Pre-Tx duration of the illness was 1.6 (0-13.5) median years. The prevalence of ID, LI, and ADHD in the sample was 11.6%, 32.5%, and 32.5%, respectively. Multivariate analysis showed that longer pre-Tx duration of illness was a significant factor for LI (OR 1.263 [95% CI, 1.033-1.544], P=0.023). Conclusion Longer pre- Tx duration may negatively affect intellectual ability in Korean children. Pre-Tx duration was more significant than the age at transplantation or total disease duration per se. Early Tx may be beneficial for cognitive function in children. This article is protected by copyright. All rights reserved.