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Published on: November 10, 2023
Specific aspects of children and adolescents undergoing lung transplantation
1Department of Thoracic Medicine, St Vincent's Hospital, Sydney, Australia. stephen.marks@gosh.nhs.uk
Insights
Pediatric lung transplantation offers improved survival and quality of life for children with end-stage lung disease. Key challenges include donor availability, infection, and growth, but outcomes are comparable to adults.
Area of Science:
- Pediatric pulmonology
- Thoracic surgery
- Transplant medicine
Background:
- Lung transplantation is a viable treatment for pediatric end-stage lung disease.
- Over 100 pediatric lung transplants are performed globally each year.
- This review focuses on unique aspects and recent advancements in pediatric lung transplantation.
Purpose of the Study:
- To review specific considerations for pediatric and adolescent lung transplant recipients.
- To provide an update on the latest developments in managing these patients.
Main Methods:
- Review of current literature and clinical practices.
- Analysis of outcomes and challenges in pediatric lung transplantation.
Main Results:
- Pediatric lung transplantation involves unique surgical challenges, immunosuppression effects, and infection risks.
- Diagnosis-specific considerations and age-related variations are important.
- Early referral, selection, and timing are critical for maximizing survival benefits.
- Infectious complications and chronic lung allograft dysfunction are significant concerns.
Conclusions:
- Lung transplantation in infants, children, and adolescents yields outcomes similar to adults.
- Specific pediatric challenges include donor organ size matching, somatic growth, psychosocial factors, adherence, and transition to adult care.
Purpose Of Review:
Lung transplantation has evolved as an accepted therapy in carefully selected children with end-stage lung disease, offering a prolonged survival and improved quality of life. Presently, more than 100 lung transplant procedures are done in children annually worldwide. Specific aspects of children and adolescents undergoing lung transplantation will be reviewed and an update on most recent developments in the management of paediatric lung transplant recipients will be given.
Recent Findings:
Certain aspects are unique to children and adolescents undergoing lung transplantation such as a challenging surgical procedure, the effects of immunosuppressant therapy, and the impact of infections on the child's developing immune system and somatic growth. The underlying diagnoses leading to lung transplantation vary considerably by age group. Early referral, careful patient selection and appropriate timing of listing are crucial to achieve the maximal survival benefit. In particular, infectious complications are a common in children. Chronic lung allograft dysfunction remains the major obstacle for a better long-term survival.
Summary:
Lung transplantation has successfully been performed in infants, children and adolescents with outcomes similar to that in adults. Specific aspects of paediatric lung transplantation include donor shortage for smaller recipients, somatic growth, psychosocial aspects and adherence, and transition to adult care.
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