{"doi":"10.1111/ctr.70057","title":"Response to “Postoperative Cognitive Dysfunction in Heart Transplantation Recipients”","abstract":"Dear Editor-in-Chief, I am writing to provide feedback on the recently published article entitled Postoperative Cognitive Dysfunction in Heart Transplantation Recipients (Issue 38: e15337, 2024) [1] in Clinical Transplantation. The article by Qin et al. offers a compelling analysis of postoperative neurocognitive disorders (NCD) in heart transplant recipients, reporting a high incidence (63.2%) of cognitive dysfunction in a study sample of 76 participants. While the findings are significant, I would like to raise some issues. First, the authors defined postoperative neurocognitive disorder (NCD) as cognitive dysfunction occurring within 12 months after surgery [2]. However, the study sample had a mean transplantation interval of 5.42 ± 2.76 years (5.20 ± 2.41 years in the NCD group). This raises questions about whether the observed cognitive deficits can still be classified as NCD, given the extended duration following the original heart transplant procedure. Second, the study exclusively used two global cognitive screening tools, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), to evaluate cognitive outcomes. While these measures are practical in clinical settings and widely used in individuals with heart failure, [3] the leading indication for heart transplantation in the study, they lack specificity in multidimensional cognitive evaluation. Comprehensive neuropsychological test batteries would provide a more nuanced assessment, identifying specific deficits, determining severity, and evaluating functional limitations [4]. Furthermore, relying on single-domain impairment as a criterion and using traditional cut-off scores (< 26 for MoCA and < 24 for MMSE) may underestimate the incidence of cognitive deficits in the study sample [3]. Addressing these methodological considerations could significantly enhance our understanding of cognitive impairment in heart transplant recipients and contribute to refining the recovery trajectory within the field of transplantation. Sincerely, Tao Zheng, MN, RN, CCRN-CSC-CMC, CHFN, PCCN PhD Candidate/Pre-doctoral Fellow The development this manuscript was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number F31NR019924 and a Sigma Theta Tau Critical Care Grant from the American Association of Critical Care Nurses. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest.","journal":"Clinical Transplantation","year":2024,"id":507664,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9436,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":960695,"name":"Tao Zheng","orcid":"0000-0003-3082-6922","position":0,"is_corresponding":true}],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-19T02:11:02.460057Z","pmid":"39688526","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}