School outcomes in children registered in the studies for pediatric liver transplant (SPLIT) consortium.

Publication Type
Journal Article
Year of Publication
Gilmour, Susan M; Sorensen, Lisa G; Anand, Ravinder; Yin, Wanrong; Alonso, Estella M; SPLIT Research Consortium
Liver Transpl
Date Published
2010 Sep
Absenteeism; Adolescent; Canada; Child; Cytomegalovirus Infections; Education, Special; Educational Measurement; Educational Status; Female; Humans; Immunosuppressive Agents; liver transplantation; Longitudinal Studies; Male; Odds Ratio; Outcome and Process Assessment, Health Care; Registries; Risk Assessment; Risk Factors; Students; Surveys and Questionnaires; Survivors; Time Factors; Treatment Outcome; Underachievement; United States

School performance is an important aspect of functional outcomes for pediatric liver transplant (LT) recipients. This longitudinal analysis conducted through the Studies of Pediatric Liver Transplantation (SPLIT) research consortium examines several indicators of school function in these patients. A total of 39 centers participated in data collection using a semistructured questionnaire designed specifically for this study. The survey queried school attendance, performance and educational outcomes including the need for special educational services. Participants included 823 of 1133 (73%) eligible patients, mean age 11.34 +/- 3.84 years, 53% female, median age at LT 4.6 (range 0.05-17.8) years, and mean interval from transplant was 5.42 +/- 2.79. Overall, 34% of patients were receiving special educational services and 20% had repeated a grade, with older participants more likely to have been held back (P = 0.0007). Missing more than 10 days of school per year was reported by one-third of the group, with this level of absence being more common in older participants (P = 0.0024) and children with shorter intervals from LT (P < 0.0001). Multivariate analysis revealed the following factors were associated with the need for special educational services; type of immunosuppression at 6 months post-LT, cyclosporine A (odds ratio [OR] = 1.8, confidence interval [CI] = 1.1-3.1), or other (OR = 4.9, 95% CI = 1.4-17.6) versus tacrolimus, symptomatic cytomegalovirus infection within 6 months of liver transplantation (OR = 3.1, CI = 1.6-6.1), and pretransplant special educational services (OR = 22.5, CI = 8.6-58.4).