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Updated: Aug 20, 2026
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Lung transplantation in young infants with interstitial pneumonia
A Moreno1, J Maestre, J Balcells
1Department of Pediatric Pulmonology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Insights
Lung transplantation is a viable treatment for infants with interstitial pneumonia, a rare condition with a poor prognosis. This study shows successful outcomes in three young patients, highlighting its potential as a therapeutic option.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Critical Care Medicine
Background:
- Interstitial pneumonia in infants is a rare condition with limited treatment options and a poor prognosis.
- Lung transplantation is an emerging therapeutic strategy for infants with end-stage respiratory failure due to interstitial pneumonia.
Purpose of the Study:
- To describe the experience and outcomes of infants with interstitial pneumonia undergoing lung transplantation.
- To evaluate the efficacy and safety of lung transplantation as a treatment for severe infantile interstitial pneumonia.
Main Methods:
- Three infants with interstitial pneumonia (surfactant protein C deficiency, chronic pneumonitis of infancy) underwent sequential double lung transplantation.
- Standard immunosuppression included tacrolimus, prednisone, and azathioprine, with basiliximab in two patients.
- Post-transplant management involved addressing complications like rejection, bronchomalacia, bronchial stenosis, and vascular anastomosis strictures.
Main Results:
- All three infants survived the lung transplant procedure and are alive with no respiratory symptoms at 8-29 months follow-up.
- Two patients experienced mild rejection episodes successfully treated with steroids.
- Complications including bronchomalacia, bronchial stenosis, and pulmonary artery anastomosis stricture were managed successfully with interventions.
Conclusions:
- Lung transplantation is a feasible and effective therapeutic option for infants suffering from interstitial pneumonia, offering a chance for improved survival and quality of life.
- Despite the rarity and poor prognosis of infantile interstitial pneumonia, lung transplantation provides a viable treatment pathway when other options are exhausted.
Objectives:
We describe our experience with infants suffering from interstitial pneumonia referred for lung transplantation.
Methods:
From April 1998 to December 2000, three infants were admitted to our lung transplantation program: a 9-month-old girl (patient 1) suffering from surfactant protein C deficiency who had high oxygen requirements (fraction of inspired oxygen: 70% to 90%), and two boys, ages 2 (patient 2) and 9 months (patient 3), who were ventilator-dependent due to chronic pneumonitis of infancy.
Results:
Patients were transplanted at the age of 5 months (patient 2) and 13 months (patients 1 and 3) at 87 to 105 days after being accepted for lung transplantation. All cases underwent a sequential double lung transplant on cardiopulmonary bypass. The immunosuppressive regime included tacrolimus, prednisone, and azathioprine. Patients 2 and 3 also received basiliximab. Two cases suffered a mild rejection episode that responded to high-dose steroids. Patient 2 was ventilator-dependent for 8 months after transplant, owing to severe bronchomalacia and left main bronchus stenosis. Bronchial stenosis resolved after pneumatic dilatation and endobronchial stenting. This patient also presented with a pulmonary artery anastomosis stricture that required percutaneous balloon dilatation. All three patients are at home, carrying out normal activities for their age, with no respiratory symptoms after a period of 8 to 29 months of follow-up.
Conclusions:
Interstitial pneumonia of infancy is a rare disease with a bad prognosis and no specific treatment; therefore, lung transplantation represents a good therapeutic option for these infants.
