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Cognitive and behavioral functioning of children listed for heart and/or lung transplantation
1Royal Brompton and Harefield NHS Trust and UCL Institute of Child Health/Great Ormond Street Hospital for Children NHS Trust, London, UK. jo.wray@btopenworld.com
Insights
Children awaiting heart/lung transplants show lower cognitive and behavioral scores than healthy peers. Congenital heart disease (CHD) and cystic fibrosis (CF) groups performed lower, highlighting pre-transplant psychological risks.
Area of Science:
- Pediatric Psychology
- Transplant Medicine
- Neurodevelopmental Disorders
Background:
- Children with end-stage heart or lung disease face potential cognitive and behavioral challenges.
- Pre-transplant assessments are crucial for understanding psychological functioning in pediatric patients.
Purpose of the Study:
- To evaluate cognitive function and behavior in children awaiting heart/lung transplantation.
- To compare these functions across different pediatric diagnostic subgroups.
Main Methods:
- Ninety-nine children (3.7-16.8 years) underwent standardized cognitive, academic, and behavioral assessments.
- Results were compared to a healthy cohort and analyzed by diagnostic group (congenital heart disease, cardiomyopathy, cystic fibrosis, primary pulmonary hypertension).
Main Results:
- Overall cognitive and academic scores were within the normal range but significantly lower than healthy controls.
- Children with congenital heart disease (CHD) or cystic fibrosis (CF) tended to have lower performance.
- Behavioral issues, especially in social competence, were noted across all diagnostic subgroups.
Conclusions:
- Pediatric patients with end-stage heart/lung disease are at elevated risk for cognitive and behavioral deficits.
- Congenital heart disease (CHD) poses a particular risk.
- Post-transplant follow-up is essential to assess the long-term impact of pre-surgical psychological functioning.
Abstract:
The objective of the study was to assess cognitive function and behavior in a group of children listed for heart and/or lung transplantation. Ninety-nine children (3.7-16.8 years) listed for heart and/or lung transplant for congenital heart disease (CHD), cardiomyopathy (CM), cystic fibrosis (CF) or primary pulmonary hypertension (PPH) were evaluated with standardized measures of cognitive function, academic ability and behavior. Results were compared with a historical cohort of healthy children and comparisons were made between the four diagnostic subgroups. Mean subtest scores, overall IQ and achievement scores were within the normal range for the total group but were significantly lower than those of the healthy group. Although there were few significant differences between the diagnostic subgroups children with CHD or CF tended to perform at a lower level than those with CM or PPH. There were some significant issues with behavior for all diagnostic subgroups, particularly in the domain of social competence. Patients with end-stage heart or lung disease are at increased risk for cognitive and/or behavioral problems, particularly those with CHD. Follow-up of these patients after transplant is important to determine the role that psychological functioning prior to surgery has in the longer term after surgery.
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