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Updated: Jul 24, 2025
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Published on: October 11, 2024
Atrial arrhythmias following lung transplant: a single pediatric center experience
Jordan Sill1, Shankar Baskar1,2, Huaiyu Zang1
1Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Insights
Atrial arrhythmia (AA) occurred in 15% of pediatric lung transplant (LTx) recipients, primarily in older children, within 10 days post-surgery. Early management of AA did not negatively impact outcomes.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Transplant Medicine
Background:
- Outcomes following pediatric lung transplant (LTx) are improving.
- Atrial arrhythmia (AA) is a known complication in adult LTx but data in pediatric recipients is limited.
Purpose of the Study:
- To describe the occurrence and management of AA in pediatric LTx recipients.
- To investigate the impact of AA on post-LTx outcomes in children.
Main Methods:
- Retrospective analysis of pediatric LTx recipients from 2014-2022.
- Investigation of AA timing, management, and effect on outcomes.
Main Results:
- 15% (3/19) of pediatric LTx recipients developed AA, occurring 9-10 days post-LTx.
- AA was observed only in older children (>12 years).
- AA did not negatively affect hospital stay duration or short-term mortality; patients were discharged on therapy, discontinued at 6 months without recurrence.
Conclusions:
- AA is an early post-operative complication in older pediatric and younger adult LTx recipients.
- Early recognition and aggressive management of AA can mitigate morbidity and mortality.
- Further research is needed to identify risk factors for AA in this population to guide preventative strategies.
Background:
Outcomes after lung transplant (LTx) in children have slowly improved. Although atrial arrhythmia (AA) is a common and adverse complication following LTx among adults, there is limited data on pediatric recipients. We detail our pediatric single-center experience while providing further insights on occurrence and management of AA following LTx.
Methods:
A retrospective analysis of LTx recipients at a pediatric LTx program from 2014 to 2022 was performed. We investigated timing of occurrence and management of AA following LTx, and its effect on post-LTx outcome.
Results:
Three out of nineteen (15%) pediatric LTx recipients developed AA. The timing of occurrence was 9-10 days following LTx. Those patients in the older age group (age >12 years old) were the only ones who developed AA. Developing AA did not have a negative effect on hospital stay duration or short-term mortality. All LTx recipients with AA were discharged home on therapy that was discontinued at 6 months for those who was on mono-therapy without recurrence of AA.
Conclusions:
AA is an early post-operative complication in older children and younger adults undergoing LTx at a pediatric center. Early recognition and aggressive management can mitigate any morbidity or mortality. Future investigations should explore factors that place this population at risk for AA in order to prevent this complication post-operatively.
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