Lung transplantation in children. Specific aspects

Arch Bronconeumol. 2013 Dec;49(12):523-8. doi: 10.1016/j.arbres.2013.09.006. Epub 2013 Nov 12.

Abstract

Lung transplantation has become in recent years a therapeutic option for infantswith terminal lung disease with similar results to transplantation in adults.In Spain, since 1996 114 children lung transplants have been performed; this corresponds to3.9% of the total transplant number.The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications areinterstitial lung disease and pulmonary hypertension.In most children a sequential double lung transplant is performed, generally with the help ofextracorporeal circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections .After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation.According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%.

Keywords: Children; Cystic fibrosis; Fibrosis quística; Hipertensión pulmonar; Interstitial pneumonia; Lung transplant; Neumopatías intersticiales; Niños; Pulmonary hypertension; Trasplante pulmonar.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Contraindications
  • Cystic Fibrosis / surgery
  • Epstein-Barr Virus Infections / complications
  • Extracorporeal Circulation
  • Graft Rejection / prevention & control
  • Graft vs Host Disease / prevention & control
  • Humans
  • Hypertension, Pulmonary / surgery
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Lung Diseases, Interstitial / surgery
  • Lung Transplantation / methods
  • Lung Transplantation / statistics & numerical data*
  • Lymphoproliferative Disorders / epidemiology
  • Lymphoproliferative Disorders / etiology
  • Lymphoproliferative Disorders / virology
  • Organ Size
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control
  • Postoperative Complications / epidemiology
  • Prognosis
  • Referral and Consultation
  • Spain
  • Survival Rate
  • Tissue Donors
  • Tissue and Organ Procurement

Substances

  • Immunosuppressive Agents