Motor development in children 0-2 years pre- and post-LTX, a prospective study

Area of Science:

• Pediatric Medicine
• Developmental Pediatrics
• Transplant Surgery

Background:

• Liver transplantation (LTX) is a critical intervention for children with end-stage liver disease.
• Assessing developmental outcomes, particularly motor skills, is crucial for long-term pediatric health post-transplant.
• Understanding the impact of LTX on gross and fine motor development in young children is essential for optimizing care.

Purpose of the Study:

• To prospectively evaluate gross and fine motor development in children under two years of age following liver transplantation (LTX).
• To identify trends in motor skill acquisition and recovery in the post-LTX period.
• To inform clinical practice regarding developmental monitoring and intervention strategies.

Main Methods:

• Prospective study involving children under two years undergoing LTX.
• Utilized the motor scale of the Bayley Scales of Infant and Toddler Development, 3rd Edition (Dutch version).
• Motor assessments were conducted pre-LTX, at hospital discharge (2-6 weeks), and at 3 months, 6 months, and 1 year post-LTX, with Z-scores calculated.

Main Results:

• Twenty-nine children (14 boys, median age 6 months at screening) participated.
• Pre-LTX, gross motor skills were delayed (Z-score -1.3), while fine motor skills were normal (Z-score 0.3).
• Both gross and fine motor skills initially declined post-LTX, with Z-scores at 1 year being -1.0 for gross motor and 0.0 for fine motor, showing a trend toward recovery.

Conclusions:

• Gross and fine motor skills in children under two years experience a decline post-liver transplantation (LTX).
• A tendency for recovery of both gross and fine motor skills is observed by one year post-LTX, reaching low-normal and normal levels, respectively.
• Continued monitoring and targeted stimulation of gross motor development are important post-LTX to support long-term physical activity and health benefits.