Risk of hearing impairment in pediatric liver transplant recipients: A single center study

被引:17
|
作者
Bucuvalas, JC [1 ]
O'Connor, A
Buschle, K
Krug, S
Ryckman, FC
Atherton, H
Alonso, MP
Balistreri, WF
机构
[1] Childrens Hosp, Med Ctr, Div Gastroenterol Hepatol & Nutr, Pediat Liver Care Ctr, Cincinnati, OH 45229 USA
[2] Cincinnati Childrens Hosp, Div Audiol, Cincinnati, OH 45229 USA
[3] Cincinnati Childrens Hosp, Div Hlth Policy & Clin Effectiveness, Cincinnati, OH 45229 USA
关键词
pediatric liver transplantation; hearing impairment; outcome;
D O I
10.1034/j.1399-3046.2003.02054.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
As survival rates following liver transplantation have increased, health care providers must assess the impact of transplantation on dimensions other than traditional medical measures. Hearing impairment may adversely impact social, emotional, cognitive, academic, and speech and language development. We hypothesized that children who undergo liver transplantation are at risk for hearing impairment due to exposure to ototoxic drugs. We conducted a review of 74 children who had undergone liver transplantation between December 1996 and September 2000 at Cincinnati Children's Hospital Medical Center. Hearing was assessed at discharge by an audiologist using age and developmentally appropriate techniques. The principal outcome measure was sensorineural hearing impairment. Independent variables were age at transplantation, United Network for Organ Sharing (UNOS) status at transplantation, primary diagnosis, post-transplant length of hospital stay, days of treatment with aminoglycosides, and days of treatment with loop diuretics. Eleven of 74 children (15%) had sensorineural hearing loss, of whom four had severe to profound hearing loss. Multivariate analyses showed that the adjusted relative risk for hearing loss in patients with hepatoblastoma was 66 and that there was a 5% increase risk for hearing loss for each additional day of hospitalization. Age at transplantation, UNOS status, and days of treatment with loop diuretics or aminoglycosides did not achieve significance in the model. Sensorineural hearing impairment occurs in a subset of pediatric patients following liver transplantation. Patients with hepatoblastoma or those who experience prolonged hospitalization after transplantation are at increased risk. Our observations are of particular importance for pediatric liver transplant recipients since the median age at transplantation is 12-18 months, a critical period for language acquisition.
引用
收藏
页码:265 / 269
页数:5
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