Parental functioning improves the developmental quotient of pediatric liver transplant recipients

Authors

  • Klara M. Posfay-Barbe,

    Corresponding author
    • Department of Pediatrics, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
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  • Rémy P. Barbe,

    1. Division of Child and Adolescent Psychiatry, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
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  • Renate Wetterwald,

    1. Division of Child and Adolescent Psychiatry, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
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  • Dominique C. Belli,

    1. Department of Pediatrics, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
    2. Division of Pediatric Gastroenterology, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
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  • Valérie A. McLin

    1. Division of Pediatric Gastroenterology, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland
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Klara Posfay-Barbe, Children's Hospital, University Hospitals of Geneva, 6 Rue Willy-Donzé, 1211 Geneva 14, Switzerland

Tel.: +41 22 382 5462; Fax: +41 22 382 5490

E-mail: Klara.PosfayBarbe@hcuge.ch

Abstract

Psychomotor development in pediatric liver transplant (LT) recipients depends on several factors. Our aim was to evaluate the importance of parental involvement and family dynamics on psychomotor development by assessing (i) children and parents individually, (ii) the parent–child relationship, and (iii) the correlation between parental functioning and patient outcome, all before and after LT. Age-appropriate scales were used before and after LT. Twenty-one patients, 19 mothers, and 16 fathers were evaluated. Developmental quotient (DQ): No subjects scored in the “very good” range. The proportion of children with deficits increased from LT to two yr: 17.6% vs. 28.6%. Subjects 0–2 yr were more likely to have normal DQ at transplant (66.7% vs. 50% for older children). Abnormal DQ was more prevalent two yr post-LT in children older at LT (p = 0.02). The mother–child relationship was normal in 59% of families pre-LT and in 67% at two yr. The relationship was more favorable when the child received a transplant as an infant (p = 0.014 at 12 months post-LT). Normal DQ was associated with higher maternal global functioning score pre-LT (p = 0.03). Paternal performance scores were higher than maternal scores. Children transplanted after two yr of age suffer greater long-term deficits than those transplanted as infants.

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