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Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Special considerations for the use of lung transplantation in pediatrics
Florian A Schmid1, Christian Benden2
1a Department of Surgery , University Hospital Zurich , Zurich , Switzerland.
Insights
Pediatric lung transplantation is a vital treatment for children with end-stage lung disease. Careful candidate selection and multidisciplinary care are crucial for successful outcomes in this unique patient group.
Area of Science:
- Pediatric Pulmonology and Thoracic Surgery
- Organ Transplantation
Background:
- Lung transplantation is an established therapy for pediatric end-stage lung diseases, improving quality of life and life expectancy.
- Pediatric lung transplant cases are often managed in adult-centric centers in Europe due to low volume, posing unique challenges.
Purpose of the Study:
- To review recent advancements in pediatric lung transplantation.
- To outline current challenges and future directions in the field.
Main Methods:
- Review of current literature and clinical practices in pediatric lung transplantation.
- Analysis of the multidisciplinary approach required for pediatric lung transplant candidates.
Main Results:
- Candidate selection is critical for maximizing survival benefit in pediatric lung transplant recipients.
- Key elements for success include interdisciplinary evaluation, early listing, preoperative education, bridging strategies, surgical planning, and postoperative care.
Conclusions:
- Pediatric lung transplantation is complex, requiring meticulous planning and execution.
- Addressing the specific needs of children and optimizing the transplant process are essential for future progress.
Abstract:
Lung transplantation has become an accepted therapy in infants, children and adolescents suffering from end-stage lung diseases, an impaired quality of life as well as a reduced life expectancy. Within Europe, pediatric lung transplantation is largely performed in predominantly adult centers due to a relatively low overall case volume. Children do represent a specific and challenging cohort facing a transplant procedure, where the selection of potential candidates becomes a crucial step to maximize net survival benefit. Therefore, interdisciplinary evaluation and early listing in view of current indications and contraindications, adequate preoperative education of the child and family members, discussion of possibly required bridging procedures in case of deterioration, appropriate technical planning of the operation, adherence to postoperative medical treatment and follow-up are all crucial steps in this demanding puzzle. In this article, the authors review recent advances in the field of pediatric lung transplantation and outline challenges in the future.
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