Size reduction of donor organs in pediatric lung transplantation.
Lobar transplantation and peripheral segmental resection allow downsizing of larger lungs for use in smaller recipients, particularly with regard to pediatric patients on the high urgency waiting list. We studied the safety and outcome of these techniques in children. All pediatric patients who underwent reduced size LTx between January 2000 and March 2009 were retrospectively reviewed and compared with pediatric patients who underwent full size LTx during the same period. Patient characteristics, intra-operative variables, and post-operative morbidity and mortality were compared. Among 28 primary LTxs, 16 (57%) were performed in reduced size technique. Preoperatively, there was a trend toward a higher rate of mechanical ventilation and a higher capillary pCO(2) in the reduced size group. Surgical procedures tended to be longer in that group. Post-operative complications, survival and functional parameters were comparable between both groups. Our study demonstrates that reduced size LTx in children is a reliable therapeutic option that provides results comparable to full size LTx. This technique might help to reduce waiting list mortality by expanding the donor pool in pediatric LTx.
Department of Pediatric Pneumology and Neonatology, Hannover Medical School, Hannover, Germany. mueller.carsten@mh-hannover.de
Carsten
C
Mueller
Gesine
G
Hansen
Manfred
M
Ballmann
Nicolaus
N
Schwerk
Andre R
AR
Simon
Heidi
H
Goerler
Martin
M
Strueber
D000293:Adolescent; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D008168:Lung / Q000033:anatomy & histology*; D016040:Lung Transplantation / Q000379:methods* / Q000401:mortality / Q000502:physiology; D008297:Male; D009929:Organ Size; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D018709:Statistics, Nonparametric; D014019:Tissue Donors / Q000706:statistics & numerical data; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome; D014850:Waiting Lists