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Developmental outcomes after pediatric heart transplantation.

Authors
  • Chinnock, Richard E1
  • Freier, M Catherin
  • Ashwal, Stephen
  • Pivonka-Jones, Jamie
  • Shankel, Tamara
  • Cutler, Drew
  • Bailey, Leonard
  • 1 Department of Pediatrics, Loma Linda University School of Medicine and Children's Hospital, Loma Linda, California 92350, USA. [email protected]
Type
Published Article
Journal
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Publication Date
Oct 01, 2008
Volume
27
Issue
10
Pages
1079–1084
Identifiers
DOI: 10.1016/j.healun.2008.07.012
PMID: 18926397
Source
Medline
Language
English
License
Unknown

Abstract

Pediatric heart transplantation has now been successfully performed for more than 20 years. As survival rates have improved, more attention is now focused on long-term outcomes. This report reviews the literature on developmental outcomes after pediatric heart transplantation. Pediatric patients undergoing heart transplantation generally can be expected to have developmental outcomes in the low-normal range, consistent with outcomes seen in other children with complex congenital heart disease requiring surgical intervention. When these children reach school age, or return to school, most can be expected to function reasonably well in mainstream school settings. A significant minority will require additional educational assistance. Approximately 10% will have significant neurologic impairment. In school, particular attention should be paid to evaluating the child for deficits in arithmetic and verbal skills. Performance may be better than predicted from IQ testing. Behavioral issues are common, with depression, concerns about social competence, and attention difficulties most frequently endorsed. This may pre-date transplantation in those who undergo transplantation during childhood and may improve with time. Parents more often report problem behaviors than teachers. Family resources and family coping skills are also strongly correlated with the child's emotions and coping skills. The pediatric heart transplant recipient's ability to transition from childhood into a happy and productive adult life can be significantly affected by his or her cognitive abilities, learning experiences, sense of self, and emotions. Attention to these factors is an important part of caring for these children.

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