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An exploratory study of the cognitive, academic, and behavioral functioning of pediatric cardiothoracic transplant
Cheryl Brosig1, Mary Hintermeyer, Jane Zlotocha
1Medical College of Wisconsin, Milwaukee, Wi, USA.
Insights
Pediatric cardiothoracic transplant recipients often experience cognitive delays and behavioral concerns, impacting academic performance. Early intervention and school-transplant team collaboration are crucial for improving outcomes.
Area of Science:
- Pediatric Medicine
- Transplant Surgery
- Developmental Psychology
Background:
- Limited data exists on the long-term cognitive, academic, and behavioral outcomes for pediatric cardiothoracic transplant survivors.
- Understanding these outcomes is vital for comprehensive post-transplant care.
Purpose of the Study:
- To assess the cognitive, behavioral, and academic functioning of pediatric patients following heart, heart/lung, or lung transplantation.
- To identify key areas of concern for transplant recipients and their families.
Main Methods:
- Exploratory, cross-sectional study of pediatric cardiothoracic transplant survivors.
- Utilized standardized measures for cognitive, academic, and behavioral assessments.
- Collected qualitative data on patient and family concerns post-transplantation.
Main Results:
- Nearly half (46%) of recipients exhibited significant cognitive delays.
- A majority achieved average academic performance in reading and spelling (78%), with a lower percentage in math (57%).
- Parents and teachers reported behavioral concerns in 17-27% of subjects.
Conclusions:
- Pediatric cardiothoracic transplant recipients may face cognitive and behavioral challenges requiring ongoing monitoring.
- Collaboration between transplant teams and educational personnel is essential for optimizing academic success.
- Psychological support is recommended to address patient and family concerns regarding quality of life and long-term prognosis.
Context:
Limited information is available regarding the cognitive, academic, and behavioral outcomes of pediatric cardiothoracic transplant recipients.
Objective:
To examine the cognitive, behavioral, and academic functioning of a group of children who have received heart, heart/lung, or lung transplants.
Design, Participants, And Setting:
An exploratory cross-sectional outcomes study of surviving pediatric cardiothoracic transplant recipients at a Midwestern pediatric hospital.
Main Outcome Measures:
Transplant recipients completed measures of cognitive and academic functioning. Parents and teachers completed measures of behavioral functioning. Parents and transplant recipients also provided qualitative data regarding their main concerns after transplantation.
Results:
On measures of cognitive functioning, 46% showed significant delays (> 2 SD below the normative population). Of those eligible for academic testing, 78% fell within the average range (within 1 SD of the normative population) for reading and spelling, and 57% fell within the average range for math. Twenty-seven percent of mothers, 11% of fathers, and 17% of teachers rated subjects as having significant behavioral concerns. Results highlight the need for close contact between transplant teams and school personnel to optimize outcomes. In addition, patients and families may benefit from psychological intervention after transplantation as there are ongoing concerns regarding life expectancy and quality of life.
