Neuodevelopmental outcomes for children transplanted under the age of 3 years.
Our previous investigations on neurodevelopmental outcomes for intestinal transplanted infants revealed that while some children were able to achieve a normal developmental outcomes, most children suffered from significant motor delays and several experienced severe cognitive delays. In our current investigation, we were especially interested in children who are transplanted before the age of 3 years because the impact of the chronic illness and nutrition impairment on the infant's developing brain may be more severe than those children who receive a liver transplant.


METHODS
We evaluated 34 infants using the Bayley Scales of Infant Development. Twenty-seven children received a liver/intestine or multivisceral transplant and seven received a liver transplant.


RESULTS
Comparison of the two groups revealed that children receiving an intestine/multivisceral transplant have much poorer outcomes. Seventy-four percent of these children were significantly delayed mentally compared to only 57.14% of the liver transplant infants. Furthermore, 42.86% of the liver-transplanted infants were actually functioning in the normal range posttransplant. The intestinal/multivisceral transplant infants' motor development shows the most striking difference, with 96.3% being severely delayed as compared to liver transplant infants in whom only 71% experienced serious delays. The neurodevelopmental impact of organ failure and transplant before the age of 3 years may depending on the type of organ transplant. Our study found that it may be more likely to expect a good outcome for liver transplant patients than for intestinal and multivisceral transplanted infants. This difference maybe due to the overall severity of the disease and the possible impact of nutritional deficits early in infancy.
Thevenin
D M
DM
Department of Pediatrics, UMMG Physician-Patient Advocacy Program, University of Miami/Miller School of Medicine, Miami, FL 33101, USA. dthevenin@med.miami.edu
Baker
A
A
Kato
T
T
Tzakis
A
A
Fernandez
M
M
Dowling
M
M
D002657:Child Development; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000502:physiology; D009420:Nervous System / Q000254:growth & development*; D014184:Transplantation, Homologous / Q000502:physiology; D016896:Treatment Outcome