Neurodevelopmental outcome of young children with extrahepatic biliary atresia 1 year after liver transplantation.
METHODS
Forty children < 2 years of age receiving extrahepatic liver transplantation were tested with the Bayley Scales of Infant Development before transplantation and again at 3 and 12 months after transplantation. Neurodevelopmental status 1 year after transplantation was organized by a descriptive statistic of normal, suspect, or delayed. Disease and transplantation variables were investigated for association with delayed neurodevelopmental outcome.


RESULTS
Before transplantation mental development was in the low-average range (92 +/- 13.2) with psychomotor development 1 SD below the norm (82.5 +/- 13). Three months after transplantation both mental (80.1 +/- 12.6) and psychomotor (69 +/- 16.1) scores dropped 1 SD, but 1 year after transplantation mental and psychomotor scores recovered to the pretransplantation level of functioning. One year after transplantation 35% of the study group was diagnosed as developmentally delayed. Delayed development was associated with decreased weight (p < 0.04), low albumin (p < 0.02), length of hospital stay (p < 0.04), and age at transplantation (p < 0.05).


CONCLUSIONS
Young children undergoing liver transplantation are at risk for developmental delay. Aggressive nutritional support before transplantation and timing of transplantation before malnutrition develops may reduce developmental delays.
Wayman
K I
KI
Department of Pediatrics, Stanford University Medical Center, California 94304-0126, USA.
Cox
K L
KL
Esquivel
C O
CO
D000367:Age Factors; D000704:Analysis of Variance; D017734:Bile Ducts, Extrahepatic; D001656:Biliary Atresia / Q000601:surgery*; D001835:Body Weight; D002657:Child Development; D002658:Developmental Disabilities / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D009460:Neurologic Examination; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D012709:Serum Albumin