Pediatric lung transplantation

Lung transplantation usually provides prolongation and marked improvement in quality of life in patients who would otherwise die from end-stage pulmonary disease. Many questions remain unanswered and important deterrents exist to long-term survival of these patients. Included in the list of challenges for the future are (1) means of increasing the donor pool by better donor identification, (2) use of adjunctive therapies that might not only enhance the quality of preservation but also extend the safe period of ischemia. (3) innovative strategies such as use of non-heart-beating donors and living donor lung transplantation, and (4) research into the prevention and treatment of OB. While gene therapy and other interventions are important opportunities on the horizon that might eventually preclude the need for transplantation, optimizing our current understanding of lung transplantation provides the only survival opportunity for patients who are incapacitated with a variety of terminal lung diseases. The spectrum of diseases being treated and the potential for rehabilitation not only separates pediatric lung transplant recipients from their adult counterparts, it also provides unique challenges and opportunities in what is a fascinating patient population.