Pulmonary retransplantation in paediatric patients: a justified therapeutic option? A single-centre experience.
OBJECTIVE
Pulmonary retransplantation remains controversial due to the increased morbidity and mortality compared with primary lung transplantation. So far, only few data about paediatric retransplantation are available. We retrospectively analysed our experience with retransplantations in children.


METHODS
Since 1994, seven pulmonary retransplantations in children were performed at our institution. We analysed pretransplant characteristics, operative parameters as well as the post-transplant outcome of these recipients and compared them to 29 patients who underwent primary lung transplantation during the same period.


RESULTS
Indications for retransplantation were bronchiolitis obliterans syndrome in six patients and primary graft failure in one patient. Pretransplant characteristics, perioperative morbidity and mortality were similar in both groups. Hospital mortality was 2/7 (29%) after retransplantation and 6/29 (21%) after primary transplantation (p = 0.64). Actuarial 3-year survival was 71% and 60% after redo and primary transplantation, respectively (p = 0.50). Development of bronchiolitis obliterans syndrome did not differ between both groups (p = 0.99).


CONCLUSIONS
In our small cohort of paediatric patients, pulmonary retransplantation was associated with an acceptable long-term outcome comparable to primary pulmonary transplantation. This differs from currently available data. However, further long-term studies including more patients and longer follow-up intervals are required.
Müller
Carsten
C
Department of Pediatric Pneumology and Neonatology, Hannover Medical School, Hannover, Germany.
Görler
Heidi
H
Ballmann
Manfred
M
Gottlieb
Jens
J
Simon
Andre R
AR
Strüber
Martin
M
Hansen
Gesine
G
D000293:Adolescent; D001989:Bronchiolitis Obliterans / Q000503:physiopathology / Q000601:surgery; D002648:Child; D005541:Forced Expiratory Volume / Q000502:physiology; D006084:Graft Rejection / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome