Evaluation of Exercise Performance, Cardiac Function, and Quality of Life in Children After Liver Transplantation

Vandekerckhove, Kristof; Coomans, Ilse; Bruyne, Elke De; Groote, Katya De; Panzer, Joseph; Wolf, Daniël De; Boone, Jan; Bruyne, Ruth De

doi:10.1097/tp.0000000000001167

Cited by 15 publications

(25 citation statements)

References 34 publications

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“…Similar to previous studies, we found both child report (only age 8‐12 years) and parent report (only age 5‐7 years) on HRQOL were lower in this study compared to published healthy norms . School functioning showed the largest difference between children after liver transplantation and healthy norms, probably based on frequent school absenteeism.…”

Section: Discussionsupporting

confidence: 87%

“…Aerobic fitness in this study was similar to that of the healthy population. Other studies in children after liver transplantation found lower predicted values for VO 2 peak , 90.5% and 77% . These studies were done in children with a mean age of 11.6 and 14.0 years.…”

Section: Discussionmentioning

confidence: 81%

“…Unfortunately, these high survival rates come at the cost of considerable co‐morbidities including hypertension, atherosclerosis, reduced growth, obesity, lowered bone density, osteoporosis, delayed motor development, increased cardiovascular risk factors, and a reduced aerobic exercise capacity . Most of these co‐morbidities are associated with lowered PA .…”

Section: Introductionmentioning

confidence: 99%

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Physical activity and aerobic fitness in children after liver transplantation

Bos

Lelieveld

Scheenstra

et al. 2019

Pediatric Transplantation

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To determine physical activity (PA), aerobic fitness, muscle strength, health‐related quality of life (HRQOL), fatigue, and participation in children after liver transplantation. Children, 6‐12 years, at least one year after liver transplantation, participated in this cross‐sectional study. Measurements: Time spent in moderate to vigorous PA (MVPA) was measured using an accelerometer, and aerobic fitness (VO2 peak) was measured by cardiopulmonary exercise testing. Muscle strength was measured by hand‐held dynamometry. Fatigue was measured using the multidimensional fatigue scale, and HRQOL with the Pediatric Quality of life Core scales and leisure activities was measured using the Children's Assessment of Participation and Enjoyment. Outcomes (medians and interquartile range (IQR)) were compared to norm values. Twenty‐six children participated in this study (14 boys, age 9.7 years, IQR 7.7;11.4). Children spent 0.8 hours/d (IQR 0.6;1.1) on MVPA. One child met the recommendation of at least 1 hour of MVPA every day of the week. Aerobic fitness was similar to norms (VO2 peak 1.4 L/min, IQR 1.1;1.7, Z‐score −0.3). Z‐scores of muscle strength ranged between −1.4 and −0.4 and HRQOL and fatigue between −2.3 and −0.4. Participation was similar to published norms (Z‐scores between −0.6 and 0.6). Young children after liver transplantation have similar MVPA patterns and aerobic fitness compared to published norms. Despite lower HRQOL, more fatigue, and less muscle strength, these children have similar participation in daily activities. Although children do well, it remains important to stimulate PA in children after liver transplantation in the context of long‐term management.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Physical activity and aerobic fitness in children after liver transplantation

Bos

Lelieveld

Scheenstra

et al. 2019

Pediatric Transplantation

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“…After deceased donor liver transplantation in children, a significantly lower outcome in the overall, emotional, psychosocial, and school functioning score in comparison with a healthy control group has been published . The same findings have been reported after living donor liver transplantation in children …”

Section: Introductionsupporting

confidence: 61%

“…Currently, there exist data regarding HRQOL after almost all single solid organ transplantations . Several studies did use the PedsQL questionnaire …”

Section: Introductionmentioning

confidence: 99%

Health‐related quality of life after combined liver and kidney transplantation in children

Schmaeschke

Lezius

Grabhorn

et al. 2017

Pediatric Transplantation

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While reduced HRQOL following isolated organ transplantation has been previously reported, there are no data in the context of children following CLKT. Twenty-three children who underwent CLKT at our institution were included in the study. The indication for CLKT was PH1 in 13 patients and ARPKD in 10 patients. Quantification of HRQOL was facilitated through the use of the PedsQL 4.0 Generic Core Scale. The results of the study were compared to healthy children and published data of children who had undergone LTx or KTx. The CLKT samples' child self-report showed good HRQOL. No statistically significant difference was found between the patients with PH1 and patients with ARPKD (P=.4). Compared to healthy children, a significant difference in the total scale score, the physical health score, and the school functioning was reported. HRQOL did not differ significantly when compared to patients following isolated LTx or KTx. To improve HRQOL after CLKT, a focus on patients' physical health, educational performances, and overall quality of life is crucial. Thus, coordinated medical care across disciplines and psychological and social support is essential to achieve this goal.

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Health‐related quality of life after pediatric liver transplantation: A systematic review

Parmar

Vandriel

2017

Liver Transpl

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With improved survival rates after pediatric liver transplantation (LT), attention is targeting improving the health-related quality of life (HRQOL) as an outcome metric. We conducted a systematic review of the literature to examine HRQOL after pediatric LT, focusing on assessment tools and factors associated with HRQOL. A literature search was conducted through PubMed, Web of Science, Ovid, and Google Scholar for all studies matching the eligibility criteria between January 2004 and September 2016. Titles and abstracts were screened independently by 2 authors and consensus for included studies was achieved through discussion. A total of 25 (2 longitudinal, 23 cross-sectional) studies were reviewed. HRQOL in pediatric LT recipients is lower than healthy controls, but it is comparable to children with chronic diseases or other pediatric solid organ transplant recipients. Domain scores were lowest in school functioning on the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale 4.0 and general health perception on the Child Health Questionnaire, the 2 most commonly used generic HRQOL instruments. Identified predictors of poor HRQOL include sleep disturbances, medication adherence, and older age at transplantation. Two recently validated disease-specific HRQOL tools, Pediatric Liver Transplant Quality of Life tool and the Pediatric Quality of Life Inventory 3.0 Transplant Module, have enabled enhanced representation of patient HRQOL, when used in conjugation with generic tools. Heterogeneity in study design and instruments prevented a quantitative, meta-analysis of the data. In conclusion, continued optimization of durable outcomes for this population mandates prioritization of research focusing on the gap of targeted intervention studies aimed at specific HRQOL subdomains and longitudinal studies to predict the trajectory of HRQOL over time. Liver Transplantation 23 361-374 2017 AASLD.

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Evaluation of Exercise Performance, Cardiac Function, and Quality of Life in Children After Liver Transplantation

Abstract: Lower physical fitness level, more deconditioning and lower health-related QOL in children after LT emphasize the importance of exercise stimulation and fitness programs. Patients on antihypertensive medication seem to be the most vulnerable group suffering from decreased physical fitness.

Cited by 15 publications

References 34 publications

Physical activity and aerobic fitness in children after liver transplantation

Physical activity and aerobic fitness in children after liver transplantation

Health‐related quality of life after combined liver and kidney transplantation in children

Health‐related quality of life after pediatric liver transplantation: A systematic review

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