title: Is lung transplantation survival better in infants? Analysis of over 80 infants.
abstract: BACKGROUND
  There have been >1,600 pediatric lung transplantations (LTx) performed worldwide with a trend toward improved outcomes over the last 25 years. The majority of these LTxs have been in older children and adolescents. Less than 4 infant (defined as ≤ 12 months of age) LTxs per year have been performed over the past 20 years, mostly in the USA. However, infant LTx outcomes have not been well documented in a multi-institutional longitudinal fashion.
  
  
  METHODS
  The United Network of Organ Sharing database was queried from October 1987 to July 2011. Of the 1,003 pediatric LTxs reported, 84 (8%) were infants. All combined transplantations were excluded.
  
  
  RESULTS
  Eighty-one infants received 84 LTxs, of which 95% had a bilateral LTx. Median age and weight at LTx was 4 months (range 0 to 11 months) and 5.3 kg (2.7 to 11.8 kg), respectively. Median ischemic time was 5.2 hours (2.0 to 10.8 hours). Overall Kaplan-Meier graft survival was similar for infants compared with other pediatric age group (OPA: >1 to 18 years) LTx recipients (half-life 4.0 years vs 3.4 years, p = 0.7). Conditional 1-year graft survival for infants was significantly higher than OPA (half-life 7.4 years vs 5.0 years, p = 0.024). Early (1987 to 2000, n = 46) and late (2001 to 2011, n = 38) era graft survival was not significantly different. Graft survival in pre-LTx ventilated infants was significantly better than pre-LTx ventilated OPA (half-life 6.1 years vs 0.9 year, p = 0.004) and was not statistically different from pre-LTx infants not on ventilatory support (half-life 6.1 years vs 2.2 years, p = 0.152). Cox regression of 5 variables (weight, donor arterial PO(2), pre-Tx ventilator, organ ischemic time, center experience) showed that survival was associated with increased center experience (p = 0.03).
  
  
  CONCLUSIONS
  Infants undergoing LTx have outcomes similar to those of all other pediatric LTx patients.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine; Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX77030, USA. mshoaibkhan@hotmail.com
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Khan
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Heinle
authors.forename: Andres X
authors.initials: AX
authors.lastname: Samayoa
authors.forename: Iki
authors.initials: I
authors.lastname: Adachi
authors.forename: Marc G
authors.initials: MG
authors.lastname: Schecter
authors.forename: George B
authors.initials: GB
authors.lastname: Mallory
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
mesh_terms: D000367:Age Factors; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016040:Lung Transplantation; D008297:Male; D012189:Retrospective Studies