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Neuropsychological outcome of infant heart transplant recipients
Marti Baum1, M Catherin Freier, Kim Freeman
1Department of Pediatrics, Division of Child Neurology, Loma Linda University, Loma Linda, CA 92350, USA.
Insights
Infant heart transplant recipients show low-average cognitive function, linked to surgical factors, medical issues, and socioeconomic status. These outcomes require attention as children mature.
Area of Science:
- Pediatric Cardiology
- Neuropsychology
- Transplantation Medicine
Background:
- Infants with congenital heart defects often require heart transplantation.
- Long-term neurodevelopmental outcomes in this population are not fully understood.
- Early life cardiac surgery can impact brain development.
Purpose of the Study:
- To evaluate the long-term neuropsychological functioning of children who received heart transplants as infants.
- To identify factors associated with neurodevelopmental outcomes in pediatric heart transplant recipients.
Main Methods:
- Fifty-five children (mean age 6.4 years) diagnosed with hypoplastic left heart syndrome or other cardiac disorders were studied.
- Risk factors assessed included birth, surgical status, medical complications, and socioeconomic variables.
- Neuropsychological testing included intelligence, achievement, visual-motor integration, language, and behavioral assessments.
Main Results:
- Mean full-scale IQ was 81 ± 19, indicating low-average intellectual functioning.
- Intraoperative/postoperative variables (e.g., bypass time, lowest posttransplant pH), long-term medical issues (infections, surgeries), and socioeconomic factors correlated with cognitive performance.
- Visual-motor skills were associated with cardiopulmonary bypass and total support duration.
Conclusions:
- Pediatric heart transplant recipients exhibit low-average long-term neuropsychological functioning.
- Outcomes are significantly influenced by intraoperative/postoperative events, subsequent medical complications, and socioeconomic determinants.
- Addressing the neuropsychological and psychosocial development of these children is crucial throughout adolescence and adulthood.
Objective:
To assess long-term neuropsychological outcomes of infant heart transplant recipients.
Study Design:
Fifty-five children (mean age, 6.4 years) with a primary diagnosis of hypoplastic left heart syndrome or other cardiac disorders participated in the study. Six areas of risk were assessed (birth; preoperative, intraoperative, and postoperative status; long-term medical complications; and socioeconomic factors). Neuropsychological evaluations included the following: Wechsler Scales of Intelligence, Wechsler Individual Achievement Test, Berry Visual Motor Integration Scale, Comprehensive Evaluation of Language Function, and Achenbach Child Behavioral Checklist.
Results:
Intellectual functioning scores revealed a mean full-scale IQ of 81 +/- 19. Intraoperative and postoperative variables (bypass time, hospital course, and lowest posttransplant pH), long-term medical complications (serious infections and posttransplant surgical procedures), and socioeconomic factors were associated with cognitive functioning. Visual-motor functioning was also related to bypass and total support time.
Conclusions:
Long-term outcomes reveal low-average neuropsychological functioning and are related to intrasurgical-postsurgical, long-term medical, and socioeconomic factors. The neuropsychological and psychosocial functioning of infant heart transplant recipients will be important to address as they mature during adolescence and adulthood.
