Lasting reduced motor function affecting quality of life after liver transplantation in children and adolescents

Assess long-term motor function and quality of life after liver transplantation in children and adolescents.

Data from movement assessment battery for children (MABC-2), neurocognitive testing and quality of life assessments from children receiving a liver transplant at Oslo University Hospital (1995-2020) were retrospectively collected from the structured testing program after transplantation.

A total of 77 pediatric patients (3-16 years), of whom 54 had repeated tests, conducted 173 MABC-2 tests. Thirty percent of the liver transplanted children scored ≤16th percentile, at risk of motor problems, and 9% scored ≤5th percentile indicating severe problems. Manual dexterity (MD) and aiming and catching (AC) (15.7% ≤5th percentile) were more affected than balance (4.3% ≤5th percentile). Children scoring ≤16 percentile for AC reported significantly lower score for social pediatric quality of life inventory compared to those with normal motor skills. Parents reported lower quality of life in children scoring ≤16 percentile compared with transplanted children with normal motor scores (p = 0.016). Large blood transfusion requirements perioperatively were associated with low MD score (p = 0.01). Motor skills did not change from the first test, performed at a median age of 6.5 (4.9-11.7) years, to the last test at 12.3 (10-15) years (p = 0.58). MABC-2 correlated with full-scale intelligence quotient (r = 0.37, p = 0.0024) and verbal comprehension index (r = 0.39, p = 0.001).

Motor competence is affected in transplanted children and did not improve over time after transplantation. Large blood transfusion requirements were associated with low manual dexterity score. Impaired motor competence affects quality of life after pediatric liver transplantation.