title: Indications for lung resection surgery and lung transplant in South American children with cystic fibrosis.
abstract: The current available literature evaluating lung resection surgery and lung transplantation in children with cystic fibrosis (CF) was reviewed through a PubMed search and references from selected studies were additionally included. Pulmonary resections, i.e. lobectomy, segmentectomy, and pneumonectomy, are seldom performed in CF. The main indications, in patients with a forced expiratory volume in 1second (FEV1) that is greater than 30% predicted, are localized bronchiectasis/atelectasis, severe hemoptysis, and bronchopleural fistula refractory to medical management. The potential benefits are decreased symptoms and pulmonary exacerbations, and an improved quality of life. Pre and postoperative intensive care is mandatory for surgical candidates. The risk of death should be taken into account when the procedure is considered. Selection for lung transplantation (LTx) candidates in children with CF in South America follows the International Society for Heart and Lung Transplantation (ISHLT) criteria. When compared to adults with CF, a poorer survival rate after LTx in children with CF has been observed in the literature, as well as in our LTx center in Brazil, reasons for which are still unknown. The main complications after LTx in children are early and late acute rejection, and infections. LTx is a therapeutic option for eligible children with CF, fulfilling the lung transplant candidacy criteria, as post-transplant survival rates are increasingly improving due to better management of the transplanted patient.
authors.affiliation: Pediatric Pulmonology Division, Instituto da Criança, Hospital das Clínicas, Medical School, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647, cep 05403-900, São Paulo, SP, Brazil. Electronic address: fabiola.adde@outlook.com.
authors.forename: Fabíola
authors.initials: F
authors.lastname: Villac Adde
authors.affiliation: Pulmonology Division, Lung Transplant Group, Heart Institute (InCor), Hospital das Clínicas, Medical School, University of São Paulo, Av. Dr Enéas de Carvalho Aguiar, 44, bloco II, cep 05403-000, São Paulo, SP, Brazil. Electronic address: silviavcampos@uol.com.br.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Vidal Campos
authors.affiliation: Pulmonology Division, Lung Transplant Group, Heart Institute (InCor), Hospital das Clínicas, Medical School, University of São Paulo, Av. Dr Enéas de Carvalho Aguiar, 44, bloco II, cep 05403-000, São Paulo, SP, Brazil. Electronic address: ricardo.teixeira@incor.usp.br.
authors.forename: Ricardo Henrique
authors.initials: RH
authors.lastname: de Oliveira Braga Teixeira
authors.affiliation: Pediatric Pulmonology Division, Instituto da Criança, Hospital das Clínicas, Medical School, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647, cep 05403-900, São Paulo, SP, Brazil. Electronic address: jocarod@uol.com.br.
authors.forename: Joaquim Carlos
authors.initials: JC
authors.lastname: Rodrigues
mesh_terms: D002648:Child; D003550:Cystic Fibrosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D016040:Lung Transplantation / Q000379:methods*; D011013:Pneumonectomy / Q000379:methods*; D018570:Risk Assessment; D013020:South America / Q000453:epidemiology
keywords: Cystic fibrosis; atelectasis; bronchiectasis; lung resection; lung transplant