The effect of liver transplantation on the neurocognitive function of children with biliary atresia
10.3760/cma.j.issn.0254-1785.2017.04.007
- VernacularTitle:肝移植对胆道闭锁患儿神经认知功能的影响
- Author:
Ying SUN
;
Hongli YU
;
Wenli YU
;
Lili JIA
;
Yiqi WENG
;
Hongyin DU
- Keywords:
Biliary atresia;
Bayley Scale of Infant Development;
Liver transplantation;
Neurocognitive function
- From:
Chinese Journal of Organ Transplantation
2017;38(4):229-233
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the mental and motor development of children with biliary atresia before and after liver transplantation,and analyze the effect of liver transplantation on neurocognitive functions.Methods Fifty children with biliary atresia who experienced living related liver transplantation were selected from Jan.2016 to Dec.2016 in our hospital,with an average age of 5 to 12 months regardless of gender.All the children were assessed by Bayley Scale of Infant Development (BSID) one day before surgery,to obtain the mental and motor development conditions.The results were indicated with Mental Development Index (MDI) and Psychomotor Development Index (PDI).The levels of preoperative ammonia,bilirubin,albumin and white blood cells were recorded,and their relationship with preoperative neurocognitive development was analyzed.The development indexes were obtained at 2nd week,3rd week and 1st month after surgery by the same method,and the neurocognitive changes were analyzed in children before and after the surgery.The effects of postoperative biliary complications,secondary operations,pneumonia infection and other complications on the postoperative development indexes one month after surgery were assessed.Results The preoperative mental and motor development was both below the standard level in 50 infants with average MDI and PDI in middle and lower state.The correlation analysis among the levels of preoperative blood ammonia,bilirubin and albumin showed statistically significant on development index (P ＜ 0.05).The levels of blood ammonia and bilirubin were negatively correlated with development index,while albumin levels showed a positive correlation.As compared with one day before liver transplantation,MDI and PDI were decreased at 2nd week after operation;the MDI increased,and PDI had no significant change at 3rd week after operation.MDI and PDI were significantly higher at 1 st month after operation than preoperation.As compared with 2nd week after operation,PDI and MDI were significantly increased at 3rd week and 1st month after operation.Postoperative persistent pneumonia infection could affect children's MDI,and biliary complications could affect PDI (P＜0.05).Concision The mental and motor development conditions of children with biliary atresia were in medium/low level,and the levels of preoperative blood ammonia,bilirubin and albumin may have significant influence.Liver transplantation may obviously improve the patient's neurocognitive function.
