Pediatric transplantationLung and Heart–Lung Transplantation in Children and Adolescents: A Long-term Single-center Experience
Section snippets
Patients
Between December 1987 and December 2007, a total of 1,002 LTx and HLTx were performed at Hannover Medical School, among them 53 procedures in 47 patients <18 years of age. Six patients received pulmonary retransplantation. Pediatric heart transplantations were excluded from this analysis.
Immunosuppression and Post-operative Management
Post-operative immunosuppression consisted of a triple maintenance therapy based on tacrolimus in combination with mycophenolate mofetil and steroids. Induction therapy was not administered. All patients were
Patient Population
Between December 1987 and December 2007, a total of 53 pediatric LTx and HLTx were performed at our institution. Of these, 31 (58.5%) were double-lung transplantations (DLTx), 6 (11.3%) were single-lung transplantations (SLTx) and 16 (30.2%) were HLTx. Twenty-nine (54.7%) patients were male and 24 (45.3%) female with a mean age of 14 ± 3.8 years (range 1 to 17 years). As shown in Figure 2, the majority of patients were adolescents rather than children. Mean height was 149 ± 22.8 cm and mean
General Considerations
In this study we have described our experience with LTx and HLTx in children and adolescents. As we have noted, the worldwide numbers of pediatric LTx and HLTx performed are low.1, 2 Indeed, a potential reason is that there is low prevalence of presenting indications for LTx in children. This, in addition to a general skepticism toward this therapeutic approach, has resulted in limited cases. According to a recently published analysis by Liou and colleagues,3 the outcome of LTx in children with
References (12)
- et al.
Registry of the International Society for Heart and Lung Transplantation: tenth official pediatric lung and heart/lung transplantation report—2007
J Heart Lung Transplant
(2007) - et al.
Registry of the International Society for Heart and Lung Transplantation: ninth official pediatric lung and heart–lung transplantation report—2006
J Heart Lung Transplant
(2006) - et al.
Lung transplantation and life extension in children with cystic fibrosis
Lancet
(1999) - et al.
Pediatric transplantation in the United States, 1996–2005
Am J Transplant
(2007) - et al.
Bronchial airway anastomotic complications after pediatric lung transplantation: incidence, cause, management, and outcome
J Thorac Cardiovasc Surg
(2006) - et al.
Long-term outcome after pulmonary retransplantation
Thorac Cardiovasc Surg
(2006)
Cited by (33)
A multicentric evaluation of pediatric lung transplantation in Italy
2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :According to the Italian protocol for urgent lung transplantation, one quarter of our cases were operated in an emergency setting; greater rates of emergency transplantation (66%) were reported only by Gorler and colleagues.5 However, if we focus on subjects at greater perioperative risk such as those in ECMO and/or mechanical ventilation (all the emergency patients in our series), the Hannover rate drops to a comparable value of 28.3%; in addition, in our population the subjects requiring preoperative cardiocirculatory assistance were more than other experiences (21% compared with 17% in Zurich,6 11% in Vienna,8 and 8% in Hannover5) and in most cases (78%) were supported with mechanical ventilation at the same time, twice as much as the number reported by Waseda and colleagues8 (16% vs 8%). In our series of patients, preoperative ECMO and/or MV is related to a prolonged and more difficult postoperative course.
Full recovery of right ventricular systolic function in children undergoing bilateral lung transplantation for severe PAH
2022, Journal of Heart and Lung TransplantationIndications and outcome after lung transplantation in children under 12 years of age: A 16-year single center experience
2022, Journal of Heart and Lung TransplantationThe influence of retransplantation on survival for pediatric lung transplant recipients
2018, Journal of Thoracic and Cardiovascular SurgeryPediatric lung transplantation in Broussais-HEGP: A 23-year experience (1990-2013)
2014, Revue de Pneumologie Clinique