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| Research article summary (published 30 Jan 2002): |
Neurodevelopmental outcome in high-risk patients after renal transplantation in early childhood.
Full Abstract
Patient and graft survival rates of pediatric renal transplant recipients are currently excellent, but there are few reports regarding the long-term neurodevelopmental outcome after renal transplantation (Tx) in early childhood. Children with renal failure from infancy would be expected to have a less favorable developmental prognosis. We report the neurodevelopmental outcome in 33 school-age children transplanted between 1987 and 1995 when < 5 yr of age. We prospectively performed a neurological examination, magnetic resonance imaging (MRI) of the brain, electroencephalograms (EEGs), audiometry, and neuropsychological tests (NEPSY), and measured cognitive performance (WISC-R); we related these results to school performance and to retrospective risk factors prior to Tx. Twenty-six (79%) children attended normal school and 76% had normal motor performance. Six of the seven children attending a special school had brain infarcts on MRI. The EEG was abnormal in 11 (35%), and five (15%) received anti-convulsive treatment after Tx. Sensorineural hearing loss was documented in six patients. The mean intelligence quotient (IQ) was 87, and 6-24% showed impairment in neuropsychological tests. The children attending a special school had been more premature, but had not had a greater number of pre- or neonatal complications. They had experienced a greater number of hypertensive crises (p = 0.002) and seizures (p = 0.03), mainly during dialysis, but the number of septic infections and the mean serum aluminum levels were not significantly greater than in the children with normal school performance. In these previously lethal diseases, the overall neurodevelopmental outcome is reassuring. However, it is of crucial importance to further minimize the risk factors prior to Tx.
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Author information
Author/s: Qvist, Erik (E); Pihko, Helena (H); Fagerudd, Pia (P); Valanne, Leena (L); Lamminranta, Sirkka (S); Karikoski, Jukka (J); Sainio, Kimmo (K); Rönnholm, Kai (K); Jalanko, Hannu (H); Holmberg, Christer (C);
Affiliation: Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland. erik.qvist(-atsign-)helsinki.fi
Journal and publication information
Publication Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
Journal: Pediatric transplantation (Pediatr Transplant), published in Denmark. (Language: eng)
Reference: 2002-Feb; vol 6 (issue 1) : pp 53-62
Dates: Created 2002/03/21; Completed 2002/05/14; Revised 2006/11/15;
PMID: 11906644, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: Pediatr Transplant. 2002 Feb;6(1):5-7. (PMID: 11906634)
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