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The impact of cognitive delay on pediatric heart transplant outcomes
Author(s) -
Prendergast Christopher,
McKane Meghann,
Dodd Debra A.,
Godown Justin
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12896
Subject(s) - medicine , contraindication , cognition , transplantation , pediatrics , intensive care medicine , psychiatry , pathology , alternative medicine
Abstract The presence of CD may be viewed as a relative contraindication to transplantation; however, its impact on pediatric HT x outcomes is poorly characterized. The aim of this study was to assess the impact of CD on pediatric HT x outcomes using academic progress as a surrogate measure of cognitive performance. The OPTN database was queried for all pediatric HT x recipients (2004‐2014) with reported academic progress. Multivariable analysis assessed the impact of DGL and the need for SE on post‐ HT x graft survival. A total of 2245 children were included: 1707 (76%) within grade level, 269 (12%) with DGL, and 269 (12%) who required SE. The need for SE was not a risk factor for post‐ HT x mortality; however, DGL was an independent risk factor for worse post‐ HT x outcomes ( AHR 1.4, 95% CI 1.02, 1.79, P =.03). Patients who require SE have similar outcomes compared to those without CD, likely secondary to significant parental involvement. Children with DGL demonstrate inferior post‐ HT x survival, which could result from less parental oversight in children perceived to maintain compliance. Ensuring adequate social support for patients with evidence of CD may help to improve outcomes.