Executive Functioning in Pediatric Solid Organ Transplant Recipients: A Meta-analytic Review

Area of Science:

• Neuroscience
• Pediatric Psychology
• Transplant Medicine

Background:

• Executive functioning (EF) assessment is crucial post-transplant due to links with poor outcomes.
• Deficits in EF can negatively impact disease management and psychosocial well-being.

Purpose of the Study:

• To compare overall and domain-specific EF in youth with kidney, heart, or liver transplants versus healthy controls.
• To identify moderators influencing EF differences between transplant recipients and healthy youth.

Main Methods:

• A meta-analysis was conducted on 20 eligible studies published up to January 2019.
• Searches were performed across PsycINFO, Pubmed, and Medline databases.

Main Results:

• Transplant recipients exhibited significantly worse overall EF (g = 0.40) compared to healthy youth.
• Specific deficits were observed in working memory (g = 0.33), processing speed (g = 0.41), attentional control (g = 0.53), and metacognitive skills (g = 0.36).
• Assessment type and time since transplantation did not moderate these EF differences.

Conclusions:

• Pediatric solid organ transplant recipients demonstrate impaired executive functioning across multiple domains.
• Children with transplants may require additional medical and academic support due to identified EF deficits.