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Pediatric lung transplantation.

Christian Benden1

  • 1Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.

Journal of Thoracic Disease
|September 22, 2017
PubMed
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Pediatric lung transplantation offers survival benefits for children with end-stage lung disease. Personalized immunosuppression and early intervention are key to managing challenges like infections and chronic lung allograft dysfunction (CLAD).

Area of Science:

  • Pediatric Pulmonology
  • Transplantation Surgery
  • Immunology

Background:

  • Pediatric lung transplantation has evolved since the 1980s into an accepted therapy for end-stage pulmonary diseases in children.
  • It offers selected pediatric patients significant survival benefits and improved quality of life.
  • Over 100 pediatric lung transplants are performed globally each year.

Purpose of the Study:

  • To review specific pediatric aspects of lung transplantation, including surgical challenges and immunosuppression effects on the developing immune system.
  • To provide an update on managing pediatric lung transplant recipients and outline future challenges.
  • To emphasize that children are not merely small adults in the context of transplantation.

Main Methods:

  • Review of current literature and clinical practices in pediatric lung transplantation.
Keywords:
Childrencystic fibrosis (CF)lung transplantationpediatrics

Related Experiment Videos

  • Analysis of indications, surgical considerations, immunosuppression strategies, and infectious complications.
  • Discussion of age-specific and regional variations in primary diagnoses for transplantation.
  • Main Results:

    • Indications for pediatric lung transplantation differ from adults, with cystic fibrosis (CF) being common, but vary by age and region.
    • Early referral, careful selection, and timely listing are critical for survival benefits.
    • Immunosuppression side effects, particularly renal damage, are common; tailored, personalized therapy and therapeutic drug monitoring are essential.

    Conclusions:

    • Infectious complications are frequent, contributing to nearly 50% of deaths within the first year post-transplant.
    • Chronic lung allograft dysfunction (CLAD) remains the primary barrier to long-term survival.
    • Personalized immunosuppression strategies are vital to mitigate side effects and improve outcomes in pediatric lung transplant recipients.