From the Pediatric Nursing Department, Faculty of Health Sciences, Başkent University, Ankara, Türkiye.
Exp Clin Transplant. 2024 Oct;22(Suppl 5):111-116. doi: 10.6002/ect.pedsymp2024.P3.
Organ transplant is a vital treatment for pediatric patients. Kidney, liver, heart, and other organ transplants can significantly improve the quality of life for children with various chronic diseases and can improve long-term survival rates. However, the effects of transplant on cognitive and educational aspects should be considered, including the effects of pre- and posttransplant treatment protocols, medications, psychosocial stress, and surgical interventions. Learning disabilities can negatively affect the child's educational life, social relationships, and overall quality of life. We aimed to examine the prevalence of learning difficulties after organ transplant, the influencing factors, and the interventions aimed at solving these problems by conducting a systematic review of existing research on learning difficulties associated with pediatric organ transplant.
For this systematic review, We searched PubMed, Cochrane, Web of Science, Science Direct, and Scopus databases to examine studies conducted during the past decade. We used the key words organ transplantation, pediatrics, and learning disabilities for our search. We included English language, full-text articles in the study; meta-analyses, systematic reviews, and case reports for which the full text was not available in English were excluded from the study.
Among an initial search result of 174 articles, 4 met the inclusion criteria. Across all studies, a consistent observation emerged that indicated a decline in neurocognitive functions among children who had undergone organ transplant. Specific areas affected included verbal intelligence, memory, reading/spelling skills, mathematical ability, motor skills, attention, and memory, collectively contributing to learning difficulties.
In light of the findings, minimizing learning difficulties in children after organ transplant necessitates strategies such as reducing transplant waiting times, seamlessly integrating children into the posttransplant school environment, and implementing specialized programs within educational institutions.
器官移植是儿科患者的重要治疗方法。肾脏、肝脏、心脏和其他器官移植可以显著提高患有各种慢性疾病的儿童的生活质量，并提高长期生存率。然而，应该考虑移植对认知和教育方面的影响，包括移植前和移植后治疗方案、药物、心理社会压力和手术干预的影响。学习障碍会对儿童的教育生活、社会关系和整体生活质量产生负面影响。我们旨在通过对儿科器官移植相关学习困难的现有研究进行系统评价，检查器官移植后学习困难的发生率、影响因素以及解决这些问题的干预措施。
为了进行这项系统评价，我们在 PubMed、Cochrane、Web of Science、Science Direct 和 Scopus 数据库中进行了搜索，以检查过去十年进行的研究。我们使用了器官移植、儿科和学习障碍等关键词进行搜索。我们纳入了研究中使用的英文全文文章；对于无法获得英文全文的元分析、系统评价和病例报告，我们将其排除在研究之外。
在最初的 174 篇文章的搜索结果中，有 4 篇符合纳入标准。在所有研究中，一致观察到接受器官移植的儿童神经认知功能下降。受影响的特定领域包括言语智力、记忆力、阅读/拼写技能、数学能力、运动技能、注意力和记忆力，这些共同导致学习困难。
鉴于这些发现，减少儿童器官移植后学习困难需要采取策略，例如减少移植等待时间，使儿童顺利融入移植后学校环境，并在教育机构内实施专门计划。
