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Impaired physical function following pediatric LT.

Amy G Feldman1, Katie Neighbors2, Shubhra Mukherjee3

  • 1Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, and Digestive Health Institute, Children's Hospital Colorado, Aurora, CO.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|February 7, 2016
PubMed
Summary
This summary is machine-generated.

Pediatric liver transplant recipients report lower physical function than healthy children one to two years post-transplant. Routine assessment and rehabilitation programs are recommended for improving physical function in these young patients.

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Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Transplantation Medicine
  • Rehabilitation Science

Background:

  • Liver transplantation (LT) is a life-saving procedure for children with end-stage liver disease.
  • Assessing the long-term physical function of pediatric LT recipients is crucial for optimizing recovery and quality of life.
  • Previous studies have focused on survival rates, with less emphasis on the spectrum of physical functioning post-transplantation.

Purpose of the Study:

  • To investigate the physical function of pediatric liver transplant recipients 12-24 months after LT.
  • To compare the physical function of these survivors to a matched healthy child population.
  • To identify factors associated with physical function in pediatric LT recipients.

Main Methods:

  • Data were collected from the Studies of Pediatric Liver Transplantation registry, focusing on patients surviving 12-24 months post-LT.
  • The Pediatric Quality of Life Inventory™ 4.0 generic core scales were administered to children aged ≥8 years and their parents.
  • Physical function scores were compared between transplant survivors and a healthy cohort, and between optimal vs. nonoptimal health groups.

Main Results:

  • Pediatric LT recipients and their parents reported significantly lower physical function scores compared to a healthy population (P < 0.001).
  • Approximately 33-35% of patients and parents reported physical function scores more than one standard deviation below the healthy mean.
  • Optimal health status was associated with significantly higher physical functioning scores (P < 0.01), and emotional functioning correlated strongly with physical function (r = 0.69, P < 0.001).

Conclusions:

  • Pediatric liver transplant recipients demonstrate reduced physical function one to two years post-transplant compared to healthy peers.
  • Factors such as primary disease, poor height z-score, prolonged hospitalization, and transplant status predict poorer physical function.
  • Routine assessment of physical function and the development of targeted rehabilitation programs are recommended for this population.