PMID- 29398281
OWN - NLM
STAT- MEDLINE
DCOM- 20191126
LR  - 20191126
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 37
IP  - 6
DP  - 2018 Jun
TI  - Neurocognitive outcomes after heart transplantation in early childhood.
PG  - 740-748
LID - S1053-2498(17)32190-3 [pii]
LID - 10.1016/j.healun.2017.12.013 [doi]
AB  - BACKGROUND: Children requiring heart transplantation (HTx) for congenital heart 
      disease (CHD) or failing anatomically normal hearts (CMP) face different 
      challenges pre-HTx. We compared the neurocognitive capabilities in pre-school-age 
      children receiving HTx for CHD vs CMP and determined factors predicting outcomes. 
      METHODS: Data were collected within a prospective multi-provincial project from 
      children who underwent HTx </=4 years of age between 1999 and 2011. At age 54 +/- 3 
      months, we obtained scores from the Wechsler Preschool and Primary Scales of 
      Intelligence for full-scale intelligence quotient (FSIQ) verbal intelligence 
      quotient (VIQ) and performance intelligence quotient (PIQ), and from the 
      Beery-Buktenica Developmental Test for visual-motor integration (VMI). Possible 
      predictive factors were collected prospectively from transplant listing. RESULTS: 
      Of the 76 patients included in the study, 61 survived to assessment, 2 were lost 
      to follow-up and 4 were excluded for genetic disorders or heart-lung transplant. 
      The CHD patients (n = 32) had significantly more previous surgeries, more severe 
      kidney injuries, more days on ventilator and in intensive care, broader human 
      leukocyte antigen (HLA) sensitization, longer cardipulmonary bypass (CPB) times 
      and higher inotropic scores than CMP patients (n = 23). Mean IQ scores for the 
      HTx children were below population norms and significantly lower in children with 
      CHD. Intellectual disability (FSIQ <70) was more common in the CHD group (p = 
      0.036). The lower VMI in CHD patients approached significance. Lower FSIQ and VMI 
      were independently associated with higher pre-HTx creatinine and lactate, longer 
      stay in intensive care and lower socioeconomic status. CONCLUSIONS: Children 
      post-HTx showed IQ and VMI scores within the borderline to low-average range, 
      with CHD children ranging significantly lower. Low scores are associated with a 
      more difficult pre- and peri-transplant course. Careful follow-up is required to 
      warrant early detection of deficits and introduction of interventions and 
      supportive measures.
CI  - Copyright (c) 2017 International Society for the Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Urschel, Simon
AU  - Urschel S
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Alberta, Edmonton, Alberta, Canada; Alberta Transplant Institute, University of 
      Alberta, Edmonton, Alberta, Canada; Department of Medical Microbiology and 
      Immunology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: 
      urschel@ualberta.ca.
FAU - Bond, Gwen Y
AU  - Bond GY
AD  - Department of Pediatrics, Glenrose Rehabilitation Hospital, University of 
      Alberta, Edmonton, Alberta, Canada.
FAU - Dinu, Irina A
AU  - Dinu IA
AD  - Department of Pediatrics, Glenrose Rehabilitation Hospital, University of 
      Alberta, Edmonton, Alberta, Canada.
FAU - Moradi, Fahime
AU  - Moradi F
AD  - Department of Pediatrics, Glenrose Rehabilitation Hospital, University of 
      Alberta, Edmonton, Alberta, Canada.
FAU - Conway, Jennifer
AU  - Conway J
AD  - Division of Pediatric Cardiology, Department of Pediatrics, University of 
      Alberta, Edmonton, Alberta, Canada.
FAU - Garcia-Guerra, Gonzalo
AU  - Garcia-Guerra G
AD  - Division of Pediatric Critical Care, University of Alberta, Edmonton, Alberta, 
      Canada.
FAU - Acton, Bryan V
AU  - Acton BV
AD  - Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, 
      Canada.
FAU - Joffe, Ari R
AU  - Joffe AR
AD  - Division of Pediatric Critical Care, University of Alberta, Edmonton, Alberta, 
      Canada.
FAU - AlAklabi, Mohammed
AU  - AlAklabi M
AD  - Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
FAU - Rebeyka, Ivan M
AU  - Rebeyka IM
AD  - Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
FAU - Robertson, Charlene M T
AU  - Robertson CMT
AD  - Division of Pediatric Critical Care, University of Alberta, Edmonton, Alberta, 
      Canada.
CN  - Western Canadian Complex Pediatric Therapies Follow-up Program
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171220
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Child, Preschool
MH  - Female
MH  - Heart Defects, Congenital/*surgery
MH  - Heart Diseases/*congenital/*surgery
MH  - *Heart Transplantation
MH  - Humans
MH  - *Intelligence Tests
MH  - Male
MH  - *Neuropsychological Tests
MH  - Postoperative Period
MH  - Prospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - IQ testing
OT  - cardiomyopathy
OT  - congenital heart disease
OT  - neurocognitive outcomes
OT  - neurodevelopment
OT  - pediatric heart transplantation
EDAT- 2018/02/06 06:00
MHDA- 2019/11/27 06:00
CRDT- 2018/02/06 06:00
PHST- 2017/10/09 00:00 [received]
PHST- 2017/12/05 00:00 [revised]
PHST- 2017/12/17 00:00 [accepted]
PHST- 2018/02/06 06:00 [pubmed]
PHST- 2019/11/27 06:00 [medline]
PHST- 2018/02/06 06:00 [entrez]
AID - S1053-2498(17)32190-3 [pii]
AID - 10.1016/j.healun.2017.12.013 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2018 Jun;37(6):740-748. doi: 
      10.1016/j.healun.2017.12.013. Epub 2017 Dec 20.