RESUMO
CONTEXT: Limited information is available regarding the cognitive, academic, and behavioral outcomes of pediatric cardiothoracic transplant recipients. OBJECTIVE: To examine the cognitive, behavioral, and academic functioning of a group of children who have received heart, heart/lung, or lung transplants. DESIGN, PARTICIPANTS, AND SETTING: An exploratory cross-sectional outcomes study of surviving pediatric cardiothoracic transplant recipients at a Midwestern pediatric hospital. MAIN OUTCOME MEASURES: Transplant recipients completed measures of cognitive and academic functioning. Parents and teachers completed measures of behavioral functioning. Parents and transplant recipients also provided qualitative data regarding their main concerns after transplantation. RESULTS: On measures of cognitive functioning, 46% showed significant delays (> 2 SD below the normative population). Of those eligible for academic testing, 78% fell within the average range (within 1 SD of the normative population) for reading and spelling, and 57% fell within the average range for math. Twenty-seven percent of mothers, 11% of fathers, and 17% of teachers rated subjects as having significant behavioral concerns. Results highlight the need for close contact between transplant teams and school personnel to optimize outcomes. In addition, patients and families may benefit from psychological intervention after transplantation as there are ongoing concerns regarding life expectancy and quality of life.
Assuntos
Transtornos do Comportamento Infantil/etiologia , Transtornos Cognitivos/etiologia , Deficiências do Desenvolvimento/etiologia , Transplante de Coração/efeitos adversos , Transplante de Coração-Pulmão/efeitos adversos , Transplante de Pulmão/efeitos adversos , Adaptação Psicológica , Adolescente , Atitude Frente a Saúde , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Estudos Transversais , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/epidemiologia , Feminino , Hospitais Pediátricos , Humanos , Lactente , Masculino , Pesquisa Metodológica em Enfermagem , Psicologia da Criança , Pesquisa Qualitativa , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento , Escalas de Wechsler , Wisconsin/epidemiologiaRESUMO
We report a case of histiocytoid cardiomyopathy in a 30-month-old child. This rare disorder has been identified in <100 patients worldwide and no previous reports of cardiac transplantation with this condition have been identified. We reviewed the clinical and pathologic findings and compared them to previous studies.