Young children with primary cholestatic liver diseases undergoing liver transplants (LTs) showed a 76% prevalence rate of motor skill delays before surgery and an increased risk for ongoing motor delays 1 year after surgery, according to a new study published in Pediatric Transplantation.

Motor delays may have long-term impacts on patients’ physical health, the authors said.

“This study highlights the need for early and ongoing motor assessment in children with [end-stage liver disease] and post-LT to be established as standard of care to ensure children receive the rehabilitation they require in order to optimize their motor development.”


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Canadian researchers enrolled 33 participants (median age at LT, 10 months, interquartile range, 7.0-20.5 months, 58% male). Most (70%) were diagnosed with biliary atresia, followed by Alagille syndrome (ALGS, 21%).

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Pre-LT motor developmental assessments showed that most (86%, 19/22) patients scored ≤10th percentile on the Alberta Infant Motor Scale. In addition, 43% (3/7) of patients scored ≥1 standard deviation below the mean gross motor quotient of the Peabody Developmental Motor Scale Second Edition.

The pre-LT assessment identified 76% of patients as being at risk of motor delay.

The increased risk of motor delay in these patients persisted post-LT (odds ratio, 11.43, 95% CI, 1.12-116.7, P =.017). Patterson et al found associations between higher international normalized ratio pre-LT and lower total motor quotient post-LT (r =-0.51, P =.003), and longer waitlist time with lower fine motor quotient post-LT (r =0.41, P =.03).

Moreover, they found positive correlations between gross motor quotient post-LT and height z-scores pre-LT (r =0.46, P =.02) and post-LT (r =0.45, P <.01).

On the other hand, the authors did not find any associations among the presence of ascites, weight z-scores, length of hospitalizations, and ages of LTs.

Reference

Patterson C, So S, Rogers A, Ng VL. Motor outcomes in young children pre‐and one‐year post‐liver transplant. Pediatr Transplant. Published online December 7, 2021. doi:10.1111/petr.14200