Impaired Motor Competence in Children With Transplanted Liver

Abstract

Children with liver transplantation had impaired motor competence compared with healthy children. Ball skills developed adversely several years after liver transplantation, and motor competence did not improve with time after transplantation. Renal function was a significant predictor for motor competence in children with liver transplantation and cholestatic liver disease.

Assessment of School Readiness in Chronic Cholestatic Liver Disease: A Pilot Study Examining Children with and without Liver Transplantation

“…In our group, the average intellectual abilities could be related to young age at transplant and high proportion (70%) of live donor liver transplantation, with shorter wait time and stringent study criteria, such as excluding patients with non-English speaking parents and abnormal muscle tone may have positively influenced the selection of patients. In adults, fewer reported neurological complications are observed in patients with living (versus deceased) donor organs, thought to be associated with enhanced graft health and shorter cold ischemic time [ 16 , 17 ] and lower use of neurotoxic immunosuppression [ 18 , 19 ]. Brain imaging documents diffuse cortical and subcortical involvement in adult patients with cirrhosis secondary to viral etiologies, associated with reduced blood flow and metabolic insufficiencies [ 16 ], and specific hypoperfusion in the caudate, thalamus, and cerebellum [ 20 ].…”

“…A study [ 20 ] utilising subjective parent report of motor functioning in LT indicated age appropriate skills, but results were not corroborated with formal motor testing. Almaas et al [ 17 ] assessed 35 liver transplant recipients (4–12 years, median 5.1 years after transplant) and found significantly poorer manual dexterity and ball and balance skills compared to healthy controls. Follow-up testing 4 years later indicated persistent motor weakness with a decline in ball skills.…”

Neurodevelopmental Outcomes in Children With Liver Diseases

“…(3,32) Results on whether motor outcomes improved over time after LTx were inconsistent; two studies showed improvement after LTx and one study did not. (9,28,29) Other studies showed that LTx itself is an important contributory factor to neurodevelopmental impairment. (19,24,27) Nevertheless, Stevenson and colleagues showed that negative effects of LTx on neurodevelopment can be reversible within one year after LTx.…”

Physical activity and aerobic fitness in children after liver transplantation

“…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 .…”

“…3 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. [4][5][6][7][8][9][10][11][12] Most of these co-morbidities are associated with lowered PA. 13,14 Low PA levels and aerobic fitness in childhood are associated with the presence of metabolic syndrome in adolescents after liver transplantation. 15 Several studies were performed to establish that children after liver transplantation have lower PA and aerobic fitness compared to healthy children.…”