Neuropsychological development of children with biliary atresia after liver transplantation
Background. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there ar...
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2021-09-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/1350 |
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| author | A. V. Syrkina I. E. Pashkova A. R. Monakhov O. V. Silina E. V. Chekletsova S. Yu. Oleshkevich I. B. Komarova O. M. Tsirulnikova |
| author_facet | A. V. Syrkina I. E. Pashkova A. R. Monakhov O. V. Silina E. V. Chekletsova S. Yu. Oleshkevich I. B. Komarova O. M. Tsirulnikova |
| author_sort | A. V. Syrkina |
| collection | DOAJ |
| description | Background. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there are no such studies in the Russian Federation.Objective: to determine the cognitive outcomes in children undergoing one-stage or two-stage surgical treatment of biliary atresia.Materials and Methods. 83 children were divided into groups: 36 children underwent transplantation without previous surgical interventions (group 1), 47 children underwent the Kasai palliative portoenterostomy (group 2). Inclusion criteria: 24 months of age or younger at the moment of transplantation, no medical history of neurological pathology. All children were examined before transplantation and at 1, 3, 6 and 12 months after liver transplantation. Psychomotor development was assessed using the Griffiths Psychomotor Development Scale for children under 24 months (translated by E.S. Keshishian), the Griffiths Intellectual Development Scale for children aged 2 to 8 years, and the Modified Checklist for Autism in Toddlers, Revised, for children 16-30 months old.Results. All children had developmental delays at the time of transplantation. Up to 50% of the children had signs of cachexia, with a shoulder circumference of less than 3 percentile. Only two children showed obvious hepatic encephalopathy in the form of depressed consciousness. After liver transplantation, 94% of group 1 children recovered their preoperative psychomotor development levels, and only 68% in group 2 made these gains. At 3 and 6 months after transplantation, about 80% of group 1 children showed normal psychomotor development, whereas in group 2, only 61% did. By 12 months after liver transplantation, the difference between the groups was more evident: 83.3% of group 1 children and only 53.2% of group 2 children were developing according to age. The difference between the groups was statistically significant (p < 0.05).Conclusion. Children who received one-stage treatment of biliary atresia and underwent liver transplantation have better neuropsychological development within a year after surgery than children with two-stage surgical treatment. |
| format | Article |
| id | doaj-art-22a8e5d9020b4fc8b0358c6fc66e78d6 |
| institution | Matheson Library |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2021-09-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-22a8e5d9020b4fc8b0358c6fc66e78d62025-08-04T14:02:11ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912021-09-01233667210.15825/1995-1191-2021-3-66-721025Neuropsychological development of children with biliary atresia after liver transplantationA. V. Syrkina0I. E. Pashkova1A. R. Monakhov2O. V. Silina3E. V. Chekletsova4S. Yu. Oleshkevich5I. B. Komarova6O. M. Tsirulnikova7Shumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian Medical Academy of Continuous Professional EducationShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityBackground. In young children, the most common liver disease leading to transplantation is biliary atresia. Liver transplantation has fundamentally improved the survival rate of children with biliary atresia. Studies on developmental outcomes in children are mostly limited to small samples; there are no such studies in the Russian Federation.Objective: to determine the cognitive outcomes in children undergoing one-stage or two-stage surgical treatment of biliary atresia.Materials and Methods. 83 children were divided into groups: 36 children underwent transplantation without previous surgical interventions (group 1), 47 children underwent the Kasai palliative portoenterostomy (group 2). Inclusion criteria: 24 months of age or younger at the moment of transplantation, no medical history of neurological pathology. All children were examined before transplantation and at 1, 3, 6 and 12 months after liver transplantation. Psychomotor development was assessed using the Griffiths Psychomotor Development Scale for children under 24 months (translated by E.S. Keshishian), the Griffiths Intellectual Development Scale for children aged 2 to 8 years, and the Modified Checklist for Autism in Toddlers, Revised, for children 16-30 months old.Results. All children had developmental delays at the time of transplantation. Up to 50% of the children had signs of cachexia, with a shoulder circumference of less than 3 percentile. Only two children showed obvious hepatic encephalopathy in the form of depressed consciousness. After liver transplantation, 94% of group 1 children recovered their preoperative psychomotor development levels, and only 68% in group 2 made these gains. At 3 and 6 months after transplantation, about 80% of group 1 children showed normal psychomotor development, whereas in group 2, only 61% did. By 12 months after liver transplantation, the difference between the groups was more evident: 83.3% of group 1 children and only 53.2% of group 2 children were developing according to age. The difference between the groups was statistically significant (p < 0.05).Conclusion. Children who received one-stage treatment of biliary atresia and underwent liver transplantation have better neuropsychological development within a year after surgery than children with two-stage surgical treatment.https://journal.transpl.ru/vtio/article/view/1350liver transplantationbiliary atresiakasai portoenterostomyneuropsychological developmentcognitive development |
| spellingShingle | A. V. Syrkina I. E. Pashkova A. R. Monakhov O. V. Silina E. V. Chekletsova S. Yu. Oleshkevich I. B. Komarova O. M. Tsirulnikova Neuropsychological development of children with biliary atresia after liver transplantation Вестник трансплантологии и искусственных органов liver transplantation biliary atresia kasai portoenterostomy neuropsychological development cognitive development |
| title | Neuropsychological development of children with biliary atresia after liver transplantation |
| title_full | Neuropsychological development of children with biliary atresia after liver transplantation |
| title_fullStr | Neuropsychological development of children with biliary atresia after liver transplantation |
| title_full_unstemmed | Neuropsychological development of children with biliary atresia after liver transplantation |
| title_short | Neuropsychological development of children with biliary atresia after liver transplantation |
| title_sort | neuropsychological development of children with biliary atresia after liver transplantation |
| topic | liver transplantation biliary atresia kasai portoenterostomy neuropsychological development cognitive development |
| url | https://journal.transpl.ru/vtio/article/view/1350 |
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