Lung transplantation in children. Specific aspects.
Lung transplantation has become in recent years a therapeutic option for infantswith terminal lung disease with similar results to transplantation in adults.In Spain, since 1996 114 children lung transplants have been performed; this corresponds to3.9% of the total transplant number.The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications areinterstitial lung disease and pulmonary hypertension.In most children a sequential double lung transplant is performed, generally with the help ofextracorporeal circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections .After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation.According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%.
Unidad de Neumología Pediátrica y Fibrosis Quística, Hospital Universitari Vall d'Hebron, Barcelona, España; Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: aroman@vhebron.net.
Antonio
A
Moreno Galdó
Juan
J
Solé Montserrat
Antonio
A
Roman Broto
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D003550:Cystic Fibrosis / Q000601:surgery; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005112:Extracorporeal Circulation; D006084:Graft Rejection / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D006976:Hypertension, Pulmonary / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D017563:Lung Diseases, Interstitial / Q000601:surgery; D016040:Lung Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D008232:Lymphoproliferative Disorders / Q000453:epidemiology / Q000209:etiology / Q000821:virology; D009929:Organ Size; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012017:Referral and Consultation; D013030:Spain; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
D007166:Immunosuppressive Agents
Children; Cystic fibrosis; Fibrosis quística; Hipertensión pulmonar; Interstitial pneumonia; Lung transplant; Neumopatías intersticiales; Niños; Pulmonary hypertension; Trasplante pulmonar