For a study, researchers sought to analyze parameters related to neurocognitive performance and to determine longitudinal neurocognitive development following liver donation. After transplantation, data from neuropsychological testing of 65 children (aged<18 years) who underwent liver transplantation at Oslo University Hospital between 1995 and 2018 were obtained from the testing program. To measure executive function, the parent-reported version of the Behavior Rating Inventory of Executive Function was employed.

On 65 patients, a total of 104 neuropsychological tests were performed. The mean full-scale IQ (FSIQ) was 91.7±14, and the mean verbal comprehension score was 92.0±14.5. The first test was done at a median of 4.1 years (IQR, 1.5-5.3 years) following transplantation and at a median age of 6.7 years (IQR, 5.4-10.5 years). There was no significant difference in FSIQ between the first test at a median age of 5.8 years (IQR, 5.2-8.5 years) and the last test at a median age of 10.8 years (87.4±12.9 vs 88.5± 13.2; P=.58). Patients who had transplantation at the age of one year (n=30) had a poorer FSIQ (87.1±12.6 vs 96.6±13.8; P=.005) and verbal comprehension index (87.3±13.8 vs 95.4±13.0; P=.020) than those who underwent transplantation at the age of one year (n=35). Age at transplantation (P=.005; corrected for cholestasis: P=.038) and transfusion of more than 80 mL/kg (P=.004; adjusted for age at transplantation: P=.046) were linked with FSIQ. 

Young age at transplantation, as well as massive blood transfusions after transplantation, are risk factors for later-life neurocognitive function. Children who got transplants before the age of one year had considerably worse neurocognitive function than those who received transplants later in infancy. After transplantation, cognitive performance did not improve.