title: School outcomes in children registered in the studies for pediatric liver transplant (SPLIT) consortium.
abstract: School performance is an important aspect of functional outcomes for pediatric liver transplant (LT) recipients. This longitudinal analysis conducted through the Studies of Pediatric Liver Transplantation (SPLIT) research consortium examines several indicators of school function in these patients. A total of 39 centers participated in data collection using a semistructured questionnaire designed specifically for this study. The survey queried school attendance, performance and educational outcomes including the need for special educational services. Participants included 823 of 1133 (73%) eligible patients, mean age 11.34 +/- 3.84 years, 53% female, median age at LT 4.6 (range 0.05-17.8) years, and mean interval from transplant was 5.42 +/- 2.79. Overall, 34% of patients were receiving special educational services and 20% had repeated a grade, with older participants more likely to have been held back (P = 0.0007). Missing more than 10 days of school per year was reported by one-third of the group, with this level of absence being more common in older participants (P = 0.0024) and children with shorter intervals from LT (P < 0.0001). Multivariate analysis revealed the following factors were associated with the need for special educational services; type of immunosuppression at 6 months post-LT, cyclosporine A (odds ratio [OR] = 1.8, confidence interval [CI] = 1.1-3.1), or other (OR = 4.9, 95% CI = 1.4-17.6) versus tacrolimus, symptomatic cytomegalovirus infection within 6 months of liver transplantation (OR = 3.1, CI = 1.6-6.1), and pretransplant special educational services (OR = 22.5, CI = 8.6-58.4).
authors.affiliation: Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada. sgilmour@cha.ab.ca
authors.forename: Susan M
authors.initials: SM
authors.lastname: Gilmour
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Sorensen
authors.forename: Ravinder
authors.initials: R
authors.lastname: Anand
authors.forename: Wanrong
authors.initials: W
authors.lastname: Yin
authors.forename: Estella M
authors.initials: EM
authors.lastname: Alonso
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D002170:Canada; D002648:Child; D003586:Cytomegalovirus Infections / Q000209:etiology; D004519:Education, Special / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D014477:Underachievement; D014481:United States
chemical_list: D007166:Immunosuppressive Agents
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