Paediatric incidence of acute rejection and obliterative bronchiolitis: a comparison with adults.
Obliterative bronchiolitis (OB) continues to be a major cause of morbidity and mortality following heart-lung transplantation. We compared the incidence of death from obliterative bronchiolitis in 19 children and 72 adults following heart-lung transplantation at our institutes. The incidence of death from OB at 2 years was 38% for children compared with 17% for adults, this difference was significant (Cox-Mantel Z value = 2.243, P < 0.05). The frequency of acute lung rejection and persistent lung rejection, previously described as risk factors for OB in adults, were significantly more common in children, P = 0.004 and P = 0.001, respectively. Average forced expiratory volume in 1 s was lower in children than in adults for each 3-month period after transplantation (P < 0.001). In conclusion, identified risk factors for the development of OB were more common, and the risk of death from OB was greater in children than in adults following heart-lung transplantation.
Division of Thoracic Diseases, Mayo Clinic, Rochester, MN 55905, USA.
J P
JP
Scott
B
B
Whitehead
M
M
de Leval
P
P
Helms
R L
RL
Smyth
T W
TW
Higenbottam
J
J
Wallwork
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001989:Bronchiolitis Obliterans / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D006084:Graft Rejection / Q000453:epidemiology*; D016041:Heart-Lung Transplantation / Q000401:mortality / Q000473:pathology / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality