The impact of cognitive delay on pediatric heart transplant outcomes

The presence of CD may be viewed as a relative contraindication to transplantation; however, its impact on pediatric HTx outcomes is poorly characterized. The aim of this study was to assess the impact of CD on pediatric HTx outcomes using academic progress as a surrogate measure of cognitive perfor...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric transplantation 2017-03, Vol.21 (2), p.np-n/a
Main Authors: Prendergast, Christopher, McKane, Meghann, Dodd, Debra A., Godown, Justin
Format: Article
Language:English
Subjects:
Adolescent
cardiac transplantation
Child
Child, Preschool
Children
Cognition Disorders - complications
Cognitive ability
Databases, Factual
development
Female
Graft Survival
Heart Failure - complications
Heart Failure - surgery
Heart Transplantation
Humans
Male
Multivariate Analysis
pediatric
Pediatrics
Proportional Hazards Models
Risk Factors
Social interactions
Survival
Time Factors
Transplantation
Transplants & implants
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The presence of CD may be viewed as a relative contraindication to transplantation; however, its impact on pediatric HTx outcomes is poorly characterized. The aim of this study was to assess the impact of CD on pediatric HTx outcomes using academic progress as a surrogate measure of cognitive performance. The OPTN database was queried for all pediatric HTx recipients (2004‐2014) with reported academic progress. Multivariable analysis assessed the impact of DGL and the need for SE on post‐HTx 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‐HTx mortality; however, DGL was an independent risk factor for worse post‐HTx 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‐HTx 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.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.12896