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Lung Development after Transplantation

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Lung Development

Part of the book series: Clinical Physiology Series ((CLINPHY))

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Abstract

Lung transplantation is now a therapeutic option for children with end-stage pulmonary parenchymal or vascular disease. En bloc heart-lung transplantation was pioneered by Reitz and colleagues and the first successful operation was carried out in 1981. Eventually, young patients were operated upon, who were generally adolescents with cystic fibrosis or the Eisenmenger syndrome. Successful single lung transplantation in adults with pulmonary fibrosis and emphysema and then in those with end-stage pulmonary vascular disease led to the extension of this technique to the pediatric age-group (43, 44). More recently, in children with pulmonary hypertensive congenital heart disease, single or bilateral sequential lung transplantation with intracardiac repair has become an acceptable alternative to heart-lung transplantation (2). The desperate lack of donor organs prompted the use of living related donor lobar lung transplantation in critically ill children (49). Using these different approaches, by 1997, 700 pediatric heart-lung and isolated lung transplantations had been carried out worldwide (32). The long-term outcome of the different procedures has not yet been compared, but the 2-year survival appears to be similar in bilateral lung and heart-lung transplantation, about 55%–60%. The incidence of rejection and bronchiolitis obliterans is not related to the indication for transplantation, or age (47). However, in a report on the St. Louis experience up to 1995, the patients transplanted at 3 years of age or less had a lower incidence of obliterative bronchiolitis than older pediatric cases (51).

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Authors
  1. Sheila G. Haworth
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  2. Alison A. Hislop
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Editors and Affiliations

  1. Service de Physiologie-Explorations Fonctionnelles, Hôpital Robert Debré, Université Paris 7, Paris, France

    Claude Gaultier

  2. INSERM Unité 319, Université Denis Diderot-Paris 7, Paris, France

    Jacques R. Bourbon

  3. The Medical Research Council Group in Lung Development, Hospital for Sick Children Research Institute, Department of Pediatrics and Physiology, University of Toronto, Toronto, Canada

    Martin Post

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© 1999 American Physiological Society

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Haworth, S.G., Hislop, A.A. (1999). Lung Development after Transplantation. In: Gaultier, C., Bourbon, J.R., Post, M. (eds) Lung Development. Clinical Physiology Series. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7537-8_16

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  • DOI: https://doi.org/10.1007/978-1-4614-7537-8_16

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