Head circumference and development in young children after renal transplantation

Motoyama, Osamu; Kawamura, Takeshi; Aikawa, Atushi; Hasegawa, Akira; Iitaka, Kikuo

doi:10.1111/j.1442-200x.2008.02653.x

Cited by 13 publications

(7 citation statements)

References 12 publications

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“…. In another study, an increase of performance IQ within 1 year following KTx was found , and additionally, an increase of head circumference and developmental quotient has been described . These conflicting results might be explained by different ages at time of development of CKD and performance of KTx.…”

Section: Discussionmentioning

confidence: 94%

Early kidney transplantation improves neurocognitive outcome in patients with severe congenital chronic kidney disease

et al. 2015

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SummaryRenal replacement therapy has become available for the majority of patients suffering from severe congenital chronic kidney disease (CKD). Data on the longterm neurocognitive outcome and the impact of early kidney transplantation (KTx) in this setting is unclear. Neurocognitive outcomes in 15 patients (11 male) with isolated congenital CKD (stage 3-5) requiring KTx at a mean age of 2.8 AE 1.3 were assessed at a mean age of 8.3 AE 1.4 years. Patients underwent neurological examination and testing for neuromotor and neurocognitive function using three independent tests. Pre-emptive KTx was performed in six patients, and nine patients were dialyzed prior to KTx for a mean period of 11.1 AE 8.6 months. Neuromotor function was abnormal in 8/15 patients. HAW-IK-III showed a global intelligence quotient (IQ) of 93.5 AE 11.4 (P = 0.05) due to a significantly reduced performance IQ of 89.1 AE 11.3 (P < 0.01). In three patients, the global IQ was clinically significantly reduced by >1 SD to <85. In patients with neuromotor dysfunction, performance IQ was lower than in patients with normal neuromotor function (83.8 AE 10.2 vs. 96.2 AE 9.0, P = 0.04). Time on dialysis was inversely correlated to verbal IQ (r = 0.78, P = 0.02). Pre-emptive KTx and duration of dialysis treatment <3 months was associated with superior neurocognitive outcome. Early (pre-emptive) KTx results in superior long-term neurocognitive outcome in children with severe congenital CKD.

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Section: Discussionmentioning

confidence: 94%

Early kidney transplantation improves neurocognitive outcome in patients with severe congenital chronic kidney disease

et al. 2015

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“…Transplantation has been found to improve deficits present during endstage renal disease, 30,31 particularly physical growth, developmental quotient, and head circumference when measured 1 year after renal transplant. 32 Outcomes in liver transplantation indicate similar developmental delay; children who have had a liver transplant have been shown to have lower intelligence than healthy children, especially when chronic liver disease occurred during infancy. Preliminary data from an ongoing Functional Outcomes Group study using patients in the Studies of Pediatric Liver Transplantation (SPLIT) registry indicate that full-scale IQ in patients who have had a liver transplant are low to normal.…”

Section: Neurocognitive Consequencesmentioning

confidence: 99%

Solid-Organ Transplantation in Childhood: Transitioning to Adult Health Care

et al. 2011

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Pediatric solid-organ transplantation is an increasingly successful treatment for solid-organ failure. With dramatic improvements in patient survival rates over the last several decades, there has been a corresponding emergence of complications attributable to pretransplant factors, transplantation itself, and the management of transplantation with effective immunosuppression. The predominant solid-organ transplantation sequelae are medical and psychosocial. These sequelae have a substantial effect on transition to adult care; as such, hurdles to successful transition of care arise from the patients, their families, and pediatric and adult health care providers. Crucial to successful transitioning is the ongoing development of a sense of autonomy and responsibility for one's own care. In this article we address the barriers to transitioning that occur with long-term survival in pediatric solid-organ transplantation. Although a particular transitioning model is not promoted, practical tools and strategies that contribute to successful transitioning of pediatric patients who have received a transplant are suggested.

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“…One study of pediatric renal transplant recipients reported an FSIQ of 87 (normative mean 100, SD 15) (126). Early renal transplantation has been suggested to improve cognitive function in infants (127). In liver transplantation patients, the FOG/SPLIT group highlighted a high prevalence of cognitive delays and learning problems, with 26% of patients exhibiting ‘mild to moderate' IQ deficits and 4% exhibiting ‘serious delays' (128).…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of children after solid organ transplantation

Kim

Marks

2014

Clinics

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Solid organ transplantation has transformed the lives of many children and adults by providing treatment for patients with organ failure who would have otherwise succumbed to their disease. The first successful transplant in 1954 was a kidney transplant between identical twins, which circumvented the problem of rejection from MHC incompatibility. Further progress in solid organ transplantation was enabled by the discovery of immunosuppressive agents such as corticosteroids and azathioprine in the 1950s and ciclosporin in 1970. Today, solid organ transplantation is a conventional treatment with improved patient and allograft survival rates. However, the challenge that lies ahead is to extend allograft survival time while simultaneously reducing the side effects of immunosuppression. This is particularly important for children who have irreversible organ failure and may require multiple transplants. Pediatric transplant teams also need to improve patient quality of life at a time of physical, emotional and psychosocial development. This review will elaborate on the long-term outcomes of children after kidney, liver, heart, lung and intestinal transplantation. As mortality rates after transplantation have declined, there has emerged an increased focus on reducing longer-term morbidity with improved outcomes in optimizing cardiovascular risk, renal impairment, growth and quality of life. Data were obtained from a review of the literature and particularly from national registries and databases such as the North American Pediatric Renal Trials and Collaborative Studies for the kidney, SPLIT for liver, International Society for Heart and Lung Transplantation and UNOS for intestinal transplantation.

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Head circumference and development in young children after renal transplantation

Abstract: In young children, physical growth, HC growth and DQ scores increased 1 year after transplantation. Dialysis and transplantation program should be planned in young children with end-stage renal failure in anticipation of growth and development of each patient.

Cited by 13 publications

References 12 publications

Early kidney transplantation improves neurocognitive outcome in patients with severe congenital chronic kidney disease

Early kidney transplantation improves neurocognitive outcome in patients with severe congenital chronic kidney disease

Solid-Organ Transplantation in Childhood: Transitioning to Adult Health Care

Long-term outcomes of children after solid organ transplantation

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