Indications for Lung Transplantation

Living reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Pediatric lung transplant is nowadays an accepted therapy in well-selected children with end-stage pulmonary disease, offering prolonged overall survival and better quality of life. Over 100 pediatric lung transplants are reported to the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Transplant Registry annually. In order to maximize posttransplant survival in children, careful candidate selection is absolutely crucial. Primary diagnostic indications for lung transplantation in children is cystic fibrosis (CF) pulmonary disease overall, followed by pulmonary hypertension and interstitial lung disease and obliterative bronchiolitis. However, there is a varying distribution of diagnostic indications depending on children’s ages. In younger children, surfactant protein deficiencies, congenital heart disease, and idiopathic pulmonary arterial hypertension are the commonest diagnoses, respectively. In older children, CF is the most frequent indication for lung transplantation. Further, marked regional differences exist worldwide regarding indications, reflecting diverse referral patterns and differences in disease management. In North America, half of the children undergoing lung transplantation have CF; in Europe, over two-thirds of children suffer with CF. Today, the ISHLT has international consensus guidelines in place, including general guidance on the selection of pediatric candidates and disease-specifics on referral and timing for listing for lung transplantation.

Keywords

Pediatric Lung transplantation (LT) Pulmonary hypertension (PH) Chronic lung disease Cystic fibrosis Interstitial lung disease Diffuse lung disease Retransplantation 

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Maureen Josephson
    • 1
  • Christian Benden
    • 2
  • Brian Hanna
    • 3
  1. 1.Division of Pulmonary MedicineThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Division of PulmonologyUniversity Hospital ZurichZurichSwitzerland
  3. 3.Division of CardiologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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