Experience with pediatric lung transplantation.
Heart-lung transplantation and lung transplantation have become accepted techniques in adult patients with end-stage cardiopulmonary disease. We report here our experience between July 1985 and March 1993 with 34 children (< 20 years) who underwent heart-lung (n = 18) or lung transplantation (n = 17). Indications for transplantation included cystic fibrosis (n = 9), congenital heart disease with Eisenmenger complex (n = 9), primary pulmonary hypertension (n = 8), pulmonary arteriovenous malformations (n = 2), desquamative interstitial pneumonia (n = 2), Proteus syndrome with multicystic pulmonary disease (n = 1), graft-versus-host disease (n = 1), rheumatoid lung disease (n = 1), and bronchiolitis obliterans and emphysema (n = 1). Twenty-six patients (76%) have survived from 1 to 88 months after transplantation; most patients have returned to an active lifestyle. Of the eight deaths, four were due to infections, two to multiorgan failure, 1 to posttransplant lymphoproliferative disease, and one to donor organ failure. Four of the patients who died had cystic fibrosis. Despite considerable morbidity related to infection, rejection, and function of the heart-lung and lung allograft in some patients, our results with this potentially lifesaving procedure in the pediatric population have been encouraging.
Noyes
B E
BE
Children's Hospital of Pittsburgh, Pennsylvania.
Kurland
G
G
Orenstein
D M
DM
Fricker
F J
FJ
Armitage
J M
JM
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004541:Eisenmenger Complex / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D016041:Heart-Lung Transplantation / Q000401:mortality*; D006801:Humans; D007223:Infant; D007239:Infections / Q000453:epidemiology / Q000401:mortality; D008171:Lung Diseases / Q000601:surgery; D016040:Lung Transplantation / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D016019:Survival Analysis