First Pediatric Lung Transplant Using the Paragonix BAROguard Preservation System

Advances in donor organ preservation can potentially improve pediatric lung transplant outcomes. The ISHLT recommends that organ temperatures remain between 4°C and 6°C and that inflation pressures remain between 10 and 15 cm H₂O during organ preservation. During traditional ice storage, temperature and inflation pressures rapidly fall below these suggested ranges. A recently developed preservation device, the Paragonix BAROguard Donor Lung Preservation System (BG) provides precise hypothermic and barometric control, ensuring that lung inflation pressure and tissue temperatures remain stable and within the ISHLT recommended range for the duration of storage. Here, we report the first clinical use of BG in a pediatric lung transplant case.

A lung transplant was performed on a high-risk pediatric recipient after lung preservation using the BG system. We evaluated the recipient for 187 days posttransplant during hospitalization.

Despite multiple significant risk factors, including neuroblastoma and hemolytic uremic syndrome complicated by thrombotic microangiopathy resulting in persistent coughing, shortness of breath, and poor oral intake, the lung transplant was successful, and the patient was discharged after 187 days.

The BG system can be safely utilized in pediatric lung transplantation, and BG preservation can be safely implemented in high-risk cases with poor clinical prognosis.