Cognitive and Academic Outcomes after Pediatric Liver Transplantation: Functional Outcomes Group (FOG) Results

This multicenter study examined prevalence of cognitive and academic delays in children following liver transplant (LT). One hundred and forty‐four patients ages 5–7 and 2 years post‐LT were recruited through the SPLIT consortium and administered the Wechsler Preschool and Primary Scale of Intelligence, 3rd Edition (WPPSI‐III), the Bracken Basic Concept Scale, Revised (BBCS‐R), and the Wide Range Achievement Test, 4th edition (WRAT‐4). Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF). Participants performed significantly below test norms on intelligence quotient (IQ) and achievement measures (Mean WPPSI‐III Full Scale IQ = 94.7 ± 13.5; WRAT‐4 Reading = 92.7 ± 17.2; WRAT‐4 Math = 93.1 ± 15.4; p < 0001). Twenty‐six percent of patients (14% expected) had ‘mild to moderate’ IQ delays (Full Scale IQ = 71–85) and 4% (2% expected) had ‘serious’ delays (Full Scale IQ ≤ 70; p < 0.0001). Reading and/or math scores were weaker than IQ in 25%, suggesting learning disability, compared to 7% expected by CDC statistics (p < 0.0001). Executive deficits were noted on the BRIEF, especially by teacher report (Global Executive Composite = 58; p < 0.001). Results suggest a higher prevalence of cognitive and academic delays and learning problems in pediatric LT recipients compared to the normal population.