Health-related quality of life in pediatric liver transplant recipients compared

[Clark]

http://www.ncbi.nlm.nih.gov/pubmed/21199214

Pediatr Transplant. 2011 May;15(3):245-53. doi: 10.1111/j.1399-3046.2010.01453.x. Epub 2010 Dec 29.
Health-related quality of life in pediatric liver transplant recipients compared with other chronic disease groups.
Limbers CA, Neighbors K, Martz K, Bucuvalas JC, Webb T, Varni JW, Alonso EM; Studies of Pediatric Liver Transplantation Functional Outcomes Group.
Collaborators (22)

Source
Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
Abstract
This cross-sectional, multicenter cohort study compares the level of HRQOL of pediatric LT recipients to children with other chronic health conditions. LT sample included 873 children who survived at least 12 months following LT. Six chronic disease samples were compiled from numerous studies, including over 800 patients with JRA, type 1 diabetes, cancer in remission, cardiac disease, end-stage renal disease, and inflammatory bowel disease. Generic HRQOL was measured from both the parental and patient perspective using the PedsQL™ 4.0 Generic Core Scales. Pediatric LT patients reported better physical health than children with JRA. According to parents, pediatric LT recipients had better HRQOL than children on renal dialysis on all domains except school functioning. Across all domains but emotional functioning, pediatric LT recipients reported significantly lower HRQOL than children with type 1 diabetes. Overall, pediatric LT patients reported HRQOL comparable to that of children who had undergone renal transplantation and patients with cancer in remission. Pediatric LT patients manifested impaired HRQOL similar to that of children with chronic diseases and these data suggest that they face ongoing challenges that warrant monitoring and indicate a need for interventions to improve their HRQOL.

PMID: 21199214 [PubMed - in process] PMCID: PMC3078219 [Available on 2012/5/1]

[Clark]

http://www.ncbi.nlm.nih.gov/pubmed/21272236

Am J Transplant. 2011 Feb;11(2):303-11. doi: 10.1111/j.1600-6143.2010.03363.x.
Cognitive and academic outcomes after pediatric liver transplantation: Functional Outcomes Group (FOG) results.
Sorensen LG, Neighbors K, Martz K, Zelko F, Bucuvalas JC, Alonso EM; Studies of Pediatric Liver Transplantation (SPLIT) and Functional Outcomes Group (FOG).
Source
Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, IL, USA. Lsorensen@childrensmemorial.org
Abstract
This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty-four patients ages 5-7 and 2 years post-LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI-III), the Bracken Basic Concept Scale, Revised (BBCS-R), and the Wide Range Achievement Test, 4th edition (WRAT-4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI-III Full Scale IQ = 94.7 ± 13.5; WRAT-4 Reading = 92.7 ± 17.2; WRAT-4 Math = 93.1 ± 15.4; p < 0001). Twenty-six percent of patients (14% expected) had 'mild to moderate' IQ delays (Full Scale IQ = 71-85) and 4% (2% expected) had 'serious' delays (Full Scale IQ ≤ 70; p < 0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC statistics (p < 0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p < 0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population.

PMID: 21272236 [PubMed - indexed for MEDLINE] PMCID: PMC3075835 [Available on 2012/2/1]

[Clark]

http://www.ncbi.nlm.nih.gov/pubmed/19846110

J Pediatr. 2010 Feb;156(2):270-6.e1. Epub 2009 Oct 28.
Cross-sectional analysis of health-related quality of life in pediatric liver transplant recipients.
Alonso EM, Limbers CA, Neighbors K, Martz K, Bucuvalas JC, Webb T, Varni JW; Studies of Pediatric Liver Transplantation (SPLIT) Functional Outcomes Group (FOG).
Collaborators (20)

Source
Department of Pediatrics, Children's Memorial Hospital, 2300 Children's Plaza, Box 65, Chicago, IL 60614, USA. e-alonso@northwestern.edu
Abstract
OBJECTIVE:
To investigate the distribution of health-related quality of life in pediatric liver transplant recipients compared with a normative population.

STUDY DESIGN:
This cross-sectional, multicenter study was conducted at select centers. Patients between 2 and 18 years of age, surviving liver transplantation by at least 12 months, were eligible. Parent/guardian fluency in English or Spanish was required. Children > or =8 years and parents of all children completed the age-appropriate versions of the PedsQL 4.0 (Mapi Research Institute, Lyon, France). Scores were compared with a sample of healthy children (n = 3911) matched by age group, sex, and race/ethnicity and with a sample of pediatric patients with cancer receiving chemotherapy and/or radiation.

RESULTS:
Participants included 65% (873/1339) of eligible patients. Mean age was 8.17 +/- 4.43 years, and 55% were female. The total and subscale scores of PedsQL 4.0 were lower than in healthy children (P < .001), with effect sizes for self-report ranging from -0.25 for Emotional Functioning to -0.68 for School Functioning. Patients and their parents reported better physical functioning than patients with cancer but similar social and school functioning. Correlations between parent and self-reports were in the moderate agreement range.

CONCLUSIONS:
Pediatric liver transplant recipients and their parents report lower health-related quality of life than control subjects with some domains equal to children receiving cancer therapy.

PMID: 19846110 [PubMed - indexed for MEDLINE]