Pediatric lung transplantation.
Pediatric lung and heart-lung transplantation are viable therapeutic interventions for end stage pulmonary parenchymal or pulmonary vascular diseases. Issues specific to pediatrics include unique diagnoses and increased need for mechanical ventilation before transplant and increased complications related to infection both before and after transplant. Although outcomes for children as a group are similar to those for adults, young children often fare better, perhaps in part due to reduced incidence of acute and chronic rejection. As in other solid organs, long-term outcomes in adolescents are poor. Increased focus on improving adherence in this age group will be important. Similar to adults, bronchiolitis obliterans remains the major late complication. Uniform treatment protocols and multicenter pediatric studies will be required to ultimately overcome this pervasive problem and improve pediatric lung transplant outcomes.
Sweet
Stuart C
SC
Department of Pediatrics, Washington University, St. Louis, MO 63110, USA. sweet@kids.wustl.edu
D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D006801:Humans; D007223:Infant; D016040:Lung Transplantation / Q000379:methods; D018579:Patient Selection; D011183:Postoperative Complications; D011788:Quality of Life; D012121:Respiration, Artificial; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome