The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: Twenty-fourth pediatric lung transplantation report — 2021; Focus on recipient characteristics

Hayes, Don; Harhay, Michael O.; Cherikh, Wida S.; Chambers, Daniel C.; Perch, Michael; Khush, Kiran K.; Hsich, Eileen; Potena, Luciano; Sadavarte, Aparna; Booker, Sarah; Singh, Tajinder P.; Zuckermann, Andreas; Stehlik, Josef

doi:10.1016/j.healun.2021.07.018

Cited by 30 publications

(35 citation statements)

References 13 publications

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Section: Overall Numbersmentioning

confidence: 99%

“…The same pattern is reflected internationally based on data from the ISHLT Thoracic Transplant Registry. The most recent Thoracic Transplant Registry Report published in 2021 comprises international data up to 2018, revealing that there has been a reduction in the number of pediatric LTX for CF in both Europe and other regions outside of North America over time 4 . In Europe, this number has declined from almost 70% of all pediatric LTX procedures (120 out of 180) in the 1992–2000 time period to below 60% (227 out of 386) in the 2010–2018 time period.…”

Section: Cystic Fibrosis: a Declining Indicationmentioning

confidence: 99%

“…More children are also undergoing LTX from pretransplant ECMO, which may elucidate why more children are also sensitized with panel reactive antibodies above 20%. 4 It is possible that this is due to the sicker ILD population aforementioned. In recent years, post-transplant survival has reached a median of more than 9 years for adults with CF according to ISHLT Registry data, 48 with comparable outcomes in children with CF.…”

Section: Further Trends Over Timementioning

confidence: 99%

“…There were a total of 2323 pediatric LTX (recipients aged <18 years) recorded worldwide from 1992 to 2018 according to the most recent ISHLT Thoracic Transplant Registry Report 4 . During the most recent era from January 2010 to June 2018, 907 pediatric LTX procedures were recorded worldwide 4 . Looking at this most recent era, this number comprises of 395 (43.6%) pediatric LTX from Europe, 417 (46.0%) from North America, and 95 (10.5%) from other countries.…”

Section: Overall Numbersmentioning

confidence: 99%

“…Recently, it was projected that this early introduction of elexacaftor/tezacaftor/ivacaftor could reduce the number of patients with advanced CF lung disease by 60%, reduce deaths by 15%, and improve median survival by 9.2 years by 2030 29 . As a result, we expect that there will be a continued decline or postponement in the need for LTX in pediatric and adult CF patients alike 4 . There have been anecdotal reports from several centers around the world of individuals with CF being able to postpone listing for LTX or even be removed from the transplant wait list, 30–32 which is corroborated by our experience at Canadian and Swiss pediatric LTX programs.…”

Section: Effect Of Cftr Modulators On Transplantationmentioning

confidence: 99%

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The changing landscape of pediatric lung transplantation

Avdimiretz

Benden

2022

Clinical Transplantation

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There has been a shift over decades in the diagnostic indications for lung transplantation in children; in particular, there has been a reduction in the proportion of pediatric cystic fibrosis (CF) patients undergoing lung transplantation early in life, and more transplants occurring in other diagnostic groups. Here, we examine trends in pediatric lung transplantation with regards to indications by analyzing data from the United Network of Organ Sharing, the International Society for Heart and Lung Transplantation Thoracic Transplant Registry, and other sources. Over the past two years, there has been a precipitous decline in both the number of transplants due to CF and the proportion of CF cases relative to the total number of transplants, likely not solely due to the COVID-19 pandemic. In 2020, primary pulmonary arterial hypertension for the firsttime surpassed CF as main indication for pediatric lung transplantation in the United States, a finding that is also reflected in international data. We discuss the effect of novel CFTR modulator therapies as a major factor leading to this shifting landscape.Based on our trending, pulmonary hypertension-related diagnoses and pediatric interstitial lung diseases are rising indications, for which we suggest adjustments of consensus guidelines around candidate selection criteria.

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Section: Overall Numbersmentioning

confidence: 99%

Section: Cystic Fibrosis: a Declining Indicationmentioning

confidence: 99%

Section: Further Trends Over Timementioning

confidence: 99%

Section: Overall Numbersmentioning

confidence: 99%

Section: Effect Of Cftr Modulators On Transplantationmentioning

confidence: 99%

See 3 more Smart Citations

The changing landscape of pediatric lung transplantation

Avdimiretz

Benden

2022

Clinical Transplantation

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Interstitial lung disease as an indication for pediatric lung transplant

Kuklinski,

Blatter

2023

Pediatric Pulmonology

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Interstitial lung disease can be an indication for lung transplant at any age, but it is a particularly common indication for lung transplant in infants. Nevertheless, not all interstitial lung diseases will lead to lung transplant in childhood. Genetic testing has aided the identification of these diseases in children. In severely affected patients, however, definitive diagnosis is not always necessary to consider referral to a transplant center. At experienced transplant centers, a multidisciplinary team educates patient families and aids in the transplant evaluation of children with interstitial lung disease. Children who have undergone transplant require lifetime immunosuppression and close surveillance, but can enjoy good quality of life for years following surgery.

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