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Survival and Outcome After Pediatric Lung Transplantation

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Solid Organ Transplantation in Infants and Children

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

Pediatric lung transplant has been first performed in 1987 with over 2200 lung transplants reported around the world. Since 1987 the median recipient survival has increased from 3.3 years to 5.8 years. Bronchiolitis obliterans is the most significant cause of death after the first year. Gender differences in survival have been described with females having decreased survival compared to male recipients. There are significant age differences in survival with 15–19 years age group having lower survival than other age groups. Bridging to transplant has been improved with the use of mechanical ventilation and ECMO not statistically affecting posttransplant survival. There are no significant survival differences based on etiology for transplant. Cystic fibrosis remains the top indication for lung transplant followed by pulmonary hypertension and interstitial lung disease. Heart‐lung transplant which was once performed in significant numbers is now performed sparingly with improvement in surgical technique along with overall inferior survival compared to lung transplant alone for similar transplant indications. Living donor lung transplantation is only performed in small numbers around the world with the greatest experience in Japan. Organ downsizing can be performed and does not impact survival. Retransplantation has inferior survival outcomes compared with primary lung transplant.

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Willemse, B.W.M., Goldfarb, S.B. (2018). Survival and Outcome After Pediatric Lung Transplantation. In: Dunn, S., Horslen, S. (eds) Solid Organ Transplantation in Infants and Children. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-07284-5_74

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