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Murine Intrapulmonary Tracheal Transplantation: A Model for Investigating Obliterative Airway Disease After Lung Transplantation
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[Invasive mechanical ventilation in cystic fibrosis: Influence in lung transplant]

M A Frías Pérez1, I Ibarra de la Rosa, E García Menor

  • 1Unidad de Cuidados Intensivos Pediátricos, Servicio de Pediatría, Hospital Universitario Reina Sofía, Córdoba, España.

Anales De Pediatria (Barcelona, Spain : 2003)
|July 17, 2009
PubMed

Insights

Lung transplantation in children with cystic fibrosis (CF) on invasive mechanical ventilation (IMV) leads to a more complex surgery and immediate recovery. While short-term survival is encouraging, long-term outcomes are significantly poorer.

Area of Science:

  • Pediatric Pulmonology
  • Transplant Surgery
  • Critical Care Medicine

Background:

  • Invasive mechanical ventilation (IMV) is a relative contraindication for lung transplantation (LT) in adult cystic fibrosis (CF) patients.
  • Limited data exists regarding the outcomes of LT in pediatric CF patients requiring IMV.

Purpose of the Study:

  • To evaluate the impact of pre-transplant IMV on the surgical outcomes and survival of pediatric CF patients undergoing LT.
  • To compare the postoperative course and survival rates between pediatric CF patients with and without pre-transplant IMV.

Main Methods:

  • Retrospective study of 21 pediatric CF patients who underwent LT over 8 years.
  • Comparison of demographic, surgical, and postoperative data between patients on IMV (n=8) and those not on IMV (n=13).
  • Analysis of graft function, rejection episodes, multiorgan failure, and survival (immediate, 1-year, and long-term).

Main Results:

  • Patients on IMV experienced longer bypass times, higher rates of tracheotomy, more rejection episodes, and multiorgan failure.
  • No significant differences in graft function or immediate/1-year survival were observed between groups.
  • Long-term survival was significantly lower in the IMV group compared to the non-IMV group.

Conclusions:

  • Pediatric CF patients on IMV undergoing LT face more complex surgery and immediate postoperative challenges.
  • While immediate and 1-year survival may be acceptable, the long-term prognosis for these patients is significantly worse.
Abstract

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