Shellmer D A, DeVito Dabbs A, Dew M A, Noll R B, Feldman H, Strauss K A, Morton D H, Vockley J, Mazariegos G V
Hillman Center for Pediatric Transplantation, School of Medicine, University of Pittsburgh, The Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15224, USA.
Pediatr Transplant. 2011 Feb;15(1):58-64. doi: 10.1111/j.1399-3046.2010.01411.x. Epub 2010 Oct 8.
MSUD is a complex metabolic disorder that has been associated with central nervous system damage, developmental delays, and neurocognitive deficits. Although liver transplantation provides a metabolic cure for MSUD, changes in cognitive and adaptive functioning following transplantation have not been investigated. In this report, we present data from 14 patients who completed cognitive and adaptive functioning testing pre- and one yr and/or three yr post-liver transplantation. Findings show either no significant change (n=8) or improvement (n=5) in IQ scores pre- to post-liver transplantation. Greater variability was observed in adaptive functioning scores, but the majority of patients evidenced no significant change (n=8) in adaptive scores. In general, findings indicate that liver transplantation minimizes the likelihood of additional central nervous system damage, providing an opportunity for possible stabilization or improvement in neurocognitive functioning.
枫糖尿症(MSUD)是一种复杂的代谢紊乱疾病,与中枢神经系统损伤、发育迟缓及神经认知缺陷有关。尽管肝移植可治愈MSUD的代谢问题,但移植后认知和适应性功能的变化尚未得到研究。在本报告中,我们展示了14例患者的数据,这些患者在肝移植前、移植后1年和/或3年完成了认知和适应性功能测试。结果显示,肝移植前后智商得分要么无显著变化(n = 8),要么有所提高(n = 5)。适应性功能得分的变异性更大,但大多数患者的适应性得分无显著变化(n = 8)。总体而言,研究结果表明肝移植可将中枢神经系统进一步受损的可能性降至最低,为神经认知功能的稳定或改善提供了机会。