Outcome of infants listed for lung or heart/lung transplantation.
BACKGROUND
Little is known about outcome, characteristics, or organ availability for infants listed for lung or heart/lung transplantation.


METHODS
Within a 45-month period at one institution, all pediatric patients who were listed for primary lung or heart/lung transplantation and who reached the end point of either transplant or death prior to transplant were identified. Outcomes for those patients listed as younger than and older than 1 year of age were compared.


RESULTS
Among 48 pediatric patients, 19 were infants less than one year of age. The median age among infants at listing was 3.7 months (range 0.5 to 8.9 months). Death before transplant occurred in 10 of 19 infants (53%) compared with 14 of 29 (48%) children. When comparing those infants who died prior to transplant with those who received organs, there were no significant differences with respect to size, blood type, age at listing, presence of pulmonary hypertension, or type of transplant for which the patient was listed. There was a trend toward poorer pre-transplant survival for infants when compared with children. Waiting times were significantly shorter for infants vs children (p = 0.02). The incidence of acute cellular rejection and serious infection was similar in the 2 groups. Infants had significantly longer hospitalization post-transplant and a trend toward poorer hospital survival, although survival at 1 year was comparable between the 2 groups.


CONCLUSIONS
The outcome for infants listed for lung or heart/lung transplantation is similar to that of children; thus, very young age should not be considered a contraindication to lung or heart/lung transplantation. Earlier diagnosis and listing may decrease pre-transplant mortality.
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Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, 19104, USA.
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Bridges
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D000293:Adolescent; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D016041:Heart-Lung Transplantation; D006801:Humans; D007223:Infant; D007902:Length of Stay; D016040:Lung Transplantation; D013997:Time Factors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome