title: Lung transplantation in children and young adults: a 20-year single-centre experience.
abstract: Lung transplantation in adults is an accepted therapeutic option, whereas there is ongoing debate on its positive impact on survival in children. We report our experience of the first 20 yrs of paediatric lung transplantation at a single centre in Austria. Patient survival, organ survival and freedom from bronchiolitis obliterans were estimated by Kaplan-Meier curves. Pre- and post-transplant parameters were assessed and their influence on patient and organ survival evaluated by univariate tests and stepwise multivariate analyses. A total of 55 transplantations were performed in 43 patients. 1- and 5-yr patient survival rates were 72.1% and 60.6%, respectively, and 52.6% of patients were found to be free from bronchiolitis obliterans syndrome at 5 yrs post-transplant. Analysing different eras of transplantation suggests an improvement over the years with a 5-yr survival rate of 70.6% in the second decade. A positive effect of pre-transplant diabetes mellitus and immunosuppression was found with the newer drug tacrolimus, and a negative effect of pre-transplant in-hospital admission was reported. A high rate of successful re-transplantation prolonged total patient survival.
authors.affiliation: Dept of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Saskia
authors.initials: S
authors.lastname: Gruber
authors.forename: Thomas
authors.initials: T
authors.lastname: Eiwegger
authors.forename: Edith
authors.initials: E
authors.lastname: Nachbaur
authors.forename: Kerstin
authors.initials: K
authors.lastname: Tiringer
authors.forename: Clemens
authors.initials: C
authors.lastname: Aigner
authors.forename: Peter
authors.initials: P
authors.lastname: Jaksch
authors.forename: Maya
authors.initials: M
authors.lastname: Keplinger
authors.forename: Walter
authors.initials: W
authors.lastname: Klepetko
authors.forename: György
authors.initials: G
authors.lastname: Lang
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Taghavi
authors.forename: Alexandra
authors.initials: A
authors.lastname: Graf
authors.forename: Irmgard
authors.initials: I
authors.lastname: Eichler
authors.forename: Thomas
authors.initials: T
authors.lastname: Frischer
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szépfalusi
mesh_terms: D000293:Adolescent; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000628:therapy*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D055815:Young Adult