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Updated: Jun 15, 2026
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Lung transplantation for pulmonary hypertension in children
1Department of Surgery, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA. huddlestonc@wustl.edu
Insights
Pediatric lung or heart-lung transplantation offers a vital treatment for children with end-stage pulmonary vascular disease. Despite challenges, it remains the primary option for those unresponsive to medical therapies.
Area of Science:
- Pediatric surgery
- Cardiothoracic transplantation
- Pulmonary hypertension management
Background:
- Pulmonary vascular disease significantly impacts children's health.
- Lung and heart-lung transplantation are established treatments for pediatric end-stage pulmonary vascular disease.
- Pulmonary hypertension necessitates advanced therapeutic interventions.
Purpose of the Study:
- To review current literature and institutional experience with pediatric lung and heart-lung transplantation.
- To analyze outcomes for children with various causes of pulmonary hypertension undergoing transplantation.
- To assess the efficacy and complications of pediatric lung transplantation for pulmonary hypertension.
Main Methods:
- Comprehensive review of existing medical literature.
- Analysis of lung transplant data from St. Louis Children's Hospital and other institutions.
- Inclusion of patient data for lung and heart-lung transplantation for pulmonary hypertension.
Main Results:
- Major complications include surgical issues (anastomotic stenoses) and graft dysfunction.
- Three-year survival rates approximate 60% for pediatric lung transplantation.
- Five-year survival rates are around 50% for pediatric lung transplantation.
Conclusions:
- Lung transplantation offers a critical, albeit challenging, option for pediatric end-stage pulmonary vascular disease.
- Transplantation remains the sole viable alternative for children with pulmonary hypertension refractory to medical treatment.
- Despite survival statistics, pediatric lung transplantation provides a life-saving intervention when other therapies fail.
Abstract:
Lung and heart-lung transplantation are accepted treatments for children with end-stage pulmonary vascular disease. This is a review of the current literature and our own experience with lung and heart-lung transplantation for children with pulmonary hypertension of a variety of causes. I reviewed the pertinent literature and our lung transplant database to acquire information and data regarding this subject. The patients include those at St. Louis Children's Hospital as well as those reported from other institutions. The major operative complications include those related to the surgical procedure itself (vascular and airway anastomotic stenoses) and those related to graft dysfunction. The 3- and 5-yr survival is approximately 60% and 50%, respectively, for children undergoing lung transplantation for pulmonary hypertension.Although these survival statistics are somewhat poor, transplantation remains the only viable alternative for children with end-stage pulmonary vascular disease failing to respond to medical therapy.
