Association of Functional, Academic, Motor, and Cognitive Deficits in Graft Failure in Pediatric Liver Transplantation

• DOI: 10.1111/ctr.70132
• Publication Date: 2025-03-28T16:16:02Z
• Authors: Conor Donnelly; Suhani S. Patel; Ian S. Jaffe; Daniyar Akizhanov; Teresa Po‐Yu Chiang; Jane J. Long; Luckmini Liyanage; Adam Griesemer; Dorry L. Segev; Allan B. Massie
• Keywords: Gross motor skill

ABSTRACT Introduction Predicting graft failure risk in pediatric liver transplantation (LT) recipients could identify areas for improving management. Persistent cognitive, motor, academic, and functional deficits are common their impact on survival following LT helps inform prediction. Methods Using SRTR data 2008–2023, we evaluated the of at time transplant to 14 years post‐LT. We compared all cause (ACGF) among patients with versus without pre‐LT 1‐year post‐LT using Cox regression, adjusting recipient characteristics. calculated an individual score ACGF. Results In 8062 median age 3 (IQR: 1, 10), 28.0%, 29.5%, 35.0%, 79.8% had cognition, academic activity, status respectively. This decreased 23.0%, 18.1%, 14.2%, 38.7% Increased hazard ACGF was noted (aHR = 1.13 (per 10% decrease), 95% CI: 1.10–1.15, p < 0.001), definite motor delay 1.60, 1.21–2.10, inability participate academics 1.49, 1.08–1.89, 0.01), but not delays cognition 0.91, 0.69–1.21, 0.19). Our predicting demonstrated improved predictive performance clinical parameters alone (C‐statistic 0.70 (0.67, 0.72) vs. 0.66 (0.64, 0.69), 0.001). Conclusions Pediatric pre‐ or higher Care should be taken assess who may benefit from intervention potentially reduce risk.