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Neuropsychological outcomes following pediatric lung transplantation
Author(s) -
Gold Anna,
Young Julia Mary,
Solomon Melinda,
Grasemann Hartmut
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24915
Subject(s) - medicine , neuropsychology , mood , executive functions , clinical psychology , interquartile range , population , transplantation , neuropsychological assessment , lung transplantation , pediatrics , cognition , psychiatry , environmental health
Objective Lung transplantation (LTx) is a treatment option for eligible children with end‐stage pulmonary diseases. Improving our understanding of longer‐term developmental outcomes in pediatric LTx recipients is important for strategized interventions targeting cognitive difficulties. Methods Neuropsychological assessments were completed for children who received LTx at our center (2009‐2017). Assessments comprised tasks of general intellect, memory, visual‐perception, academics, and executive functioning as well as caregiver questionnaires of adaptive, executive, emotional, and behavioral functioning. Results were compared to age‐matched population norms. Between‐group nonparametric tests were performed pre‐LTx vs post‐LTx and for children with a primary diagnosis of cystic fibrosis (CF) vs other diagnoses (non‐CF). Results Neuropsychological outcomes were assessed for 21 children post‐LTx, with a median age (interquartile range) at the time of transplant of 11.52 (6.89, 14.12) years. Eleven children completed pre‐ and post‐transplant assessments and within this group, improvements for verbal learning ( P = .02), aspects of mood, behavior, and adaptive functioning were observed over time (all P < .05). Post‐transplant whole group analysis suggested age‐appropriate abilities across most cognitive domains, with a relative weakness for executive functioning. Emotional or behavioral difficulties were not endorsed by caregivers. Across pulmonary diagnoses, higher levels of emotional, behavioral, and executive functioning difficulty were reported in the non‐CF group (all P < .05). Conclusions Overall, LTx has a positive impact on cognitive functioning, particularly learning, adaptive functioning, mood, and behavior. Children transplanted for non‐CF related diseases demonstrated greater challenges, highlighting the need for targeted assessments and interventions across the transplant process to support the complex needs of this population.