Pediatric transplantation · 2024
Deficits in Pre- and Post-transplant Functional, Motor, and Cognitive Deficits Associated With Graft Failure and Mortality in Pediatric Heart Transplant Recipients.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Donnelly Conor, Patel Suhani S, Chiang Teresa Po-Yu, Liyanage Luckmini, Long Jane J, Levan Macey L, Varma Manu R, Singh Rakesh K, Segev Dorry L, Massie Allan B
Аннотация
BACKGROUND: Pretransplant functional, motor, cognitive, and academic deficits are common in pediatric patients requiring heart transplantation (HT); some persist post-HT. We assessed the association between these quality of life (QoL) deficits and post-HT outcomes.
METHODS: Using SRTR data 2008-2023, we evaluated the functional, motor, cognitive, and academic status of pediatric HT recipients from listing to 15 years post-HT. We compared all-cause graft survival among patients with vs. without pre-HT deficits using Cox regressions. Among patients with a functioning graft at 1 year, we assessed the association between deficits at that time and subsequent graft failure.
RESULTS: In 6153 HT recipients, 85.3% had pre-HT functional status ≤ 80%, 53.1% of patients could not tolerate a full academic load; this decreased to 15.2% and 15.0% postoperatively, and was sustained. Definite or probable cognitive deficits were seen in 17.4% of patients and motor delays in 18.6%; both remained stable post-HT at 18.0% and 16.4%, respectively. Graft survival was worse in those with either pre- or post-HT deficits in functional status. Worse pre-HT functional status was associated with risk of graft failure (adjusted hazard ratio [aHR] per 10% decrease = 1.03 1.06 1.08, p < 0.001); worse 1-year post-HT functional status was much more strongly associated with risk of graft failure (aHR = 1.13 1.18 1.23, p < 0.001).
CONCLUSION: Pediatric HT recipients with decreased functional status are at higher risk for graft failure and mortality. These patients may benefit from early intervention aimed at improving functional status.
METHODS: Using SRTR data 2008-2023, we evaluated the functional, motor, cognitive, and academic status of pediatric HT recipients from listing to 15 years post-HT. We compared all-cause graft survival among patients with vs. without pre-HT deficits using Cox regressions. Among patients with a functioning graft at 1 year, we assessed the association between deficits at that time and subsequent graft failure.
RESULTS: In 6153 HT recipients, 85.3% had pre-HT functional status ≤ 80%, 53.1% of patients could not tolerate a full academic load; this decreased to 15.2% and 15.0% postoperatively, and was sustained. Definite or probable cognitive deficits were seen in 17.4% of patients and motor delays in 18.6%; both remained stable post-HT at 18.0% and 16.4%, respectively. Graft survival was worse in those with either pre- or post-HT deficits in functional status. Worse pre-HT functional status was associated with risk of graft failure (adjusted hazard ratio [aHR] per 10% decrease = 1.03 1.06 1.08, p < 0.001); worse 1-year post-HT functional status was much more strongly associated with risk of graft failure (aHR = 1.13 1.18 1.23, p < 0.001).
CONCLUSION: Pediatric HT recipients with decreased functional status are at higher risk for graft failure and mortality. These patients may benefit from early intervention aimed at improving functional status.