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Adaptive functioning and its correlates after intestine and liver transplantation

Authors

  • Diana A. Shellmer,

    Corresponding author
    1. Hillman Center for Pediatric Transplantation, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
    • Department of Pediatric Transplant Surgery, School of Medicine University of Pittsburgh, Pittsburgh, PA, USA
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  • Annette DeVito Dabbs,

    1. Department of Acute and Tertiary Care Nursing, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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  • Mary Amanda Dew,

    1. Departments of Psychiatry, Psychology, Epidemiology and Biostatistics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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  • Lauren Terhorst,

    1. Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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  • Robert B. Noll,

    1. Department of Pediatrics, The Children's Hospital of Pittsburgh of UPMC, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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  • Beverly Kosmach-Park,

    1. Hillman Center for Pediatric Transplantation, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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  • George Mazariegos

    1. Department of Pediatric Transplant Surgery, School of Medicine University of Pittsburgh, Pittsburgh, PA, USA
    2. Hillman Center for Pediatric Transplantation, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Diana A. Shellmer, PhD, The University of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Faculty Pavilion, Floor 6, Pittsburgh, PA 15224, USA

Tel.:+1 412 692 6110

Fax: +1 412 692 6117

E-mail: diana.shellmer@chp.edu

Abstract

In this cross-sectional study, we compared levels of adaptive functioning and examined potential correlates of adaptive functioning in 18 pediatric intestine (ITX) and 22 liver (LTX) recipients transplanted between June 2003 and March 2009. Family caregivers completed the ABAS-II scale and provided socio-demographic information regarding recipients' age at transplantation, gender, ethnicity, time since transplantation, and caregivers' role, ethnicity, education, and family income. Overall adaptive functioning and all three adaptive functioning subdomain scores were significantly lower in ITX patients compared with LTX patients (p  0.04) and compared with the general population normative mean (p  0.003). Significant correlates of adaptive functioning after abdominal transplant included type of transplant procedure (= −0.4, p = 0.02), gender (= 0.4, p = 0.01), and educational level of caregiver (= 0.5, p = 0.003) and together explained 45% of the variance in overall adaptive functioning. Findings provide new information regarding everyday functioning outcomes of ITX patients, add to existing data regarding non-medical outcomes for LTX patients, and highlight the need for ongoing monitoring and intervention following transplantation to enhance outcomes.

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