Pediatric Lung Transplantation

Abstract

Pediatric lung transplant is a viable option for treatment of end-stage lung disease in children, with > 100 pediatric lung transplants reported to the Registry of the International Society of Heart and Lung Transplantation each year. Long-term success is limited by availability of donor organs, debilitation as a result of chronic disease, impaired mucus clearance resulting from both surgical and pharmacologic interventions, increased risk for infection resulting from immunosuppression, and most importantly late complications, such as chronic lung allograft dysfunction. Opportunities for investigation and innovation remain in all of these domains: (1) Ex vivo lung perfusion is a promising technology with the potential for increasing the lung donor pool, (2) evolving extracorporeal support strategies coupled with effective rehabilitation will effectively bridge critically ill patients to transplant, and most importantly, (3) research efforts intended to increase our understanding of the underlying mechanisms of chronic lung allograft dysfunction will ultimately lead to the development of effective therapies to prevent or treat the variety of chronic lung allograft dysfunction presentations.

Absence of evidence that respiratory viral infections influence pediatric lung transplantation outcomes: Results of the CTOTC-03 study

“…[1][2][3] Between 25% and 40% of lung transplant recipients will die directly or indirectly from CLAD. However, longterm graft and patient survivals have not improved substantially over the same period and remain significantly worse than outcomes for recipients of heart, liver, and kidney allografts.…”

“…The incidence of bronchiolitis obliterans syndrome (BOS), the most common form of CLAD, is 50% at 5 years in children and roughly 80% between 5 and 10 years in adults. [1][2][3] Between 25% and 40% of lung transplant recipients will die directly or indirectly from CLAD. 3 Although retransplant for CLAD is feasible, its utility is limited by organ availability and poorer survival after the second transplant.…”

Pediatric lung transplantation in the largest lung transplantation center of China: embarking on a long road

“…Another serious complication is airway complication which also frequently occurs after pediatric LT. The incidence of airway compliance in pediatric lung transplant recipients was reported to be similar with that in adult lung transplant recipients 5 . In our study, two patients had anastomotic stenosis after LT. One child developed right bronchial anastomotic stenosis.…”

“…Specifically, the most common indication for pediatric LT in the western world is cystic fibrosis which is rarely reported in China 3 , 4 . Other leading indications for pediatric LT consist of idiopathic pulmonary arterial hypertension (IPAH), bronchiolitis obliterans (BO) following bone marrow transplantation (BMT), surfactant dysfunction disorders and interstitial lung disease (ILD) 5 . The aim of this study was to share our experiences in pediatric LT conducted at our center, the largest specialized institution for LT in the whole country of China.…”

Children with Special Health Care Needs: Comparison of the Effects of Home Care Setting, Prescribed Pediatric Extended Care Setting, and Long-Term Care Setting on Child and Family Health Outcomes and Health Care Service Use

“…However, up to 79% of these children survive with surgery and remain eventfree for many years (Sweet, Wong, Webber, Horslen, Guidinger, Fine, & Magee, 2006).…”