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Updated: Jul 5, 2026
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
Single-Center Experience in Pediatric Lung Transplantation: Clinical Characteristics, Survival, and Post-Transplant
Mohammed Albalawi1,2, Rayid Abdulqawi1,2, Abdullah Alkhani3
1Lung Health Center, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Background:
Pediatric lung transplantation remains a life-saving option for selected children and adolescents with end-stage lung disease. We aimed to describe clinical characteristics, survival, post-transplant morbidity, and exploratory factors associated with mortality in a single-center Saudi cohort.
Methods:
We retrospectively reviewed all pediatric patients who underwent lung transplantation between January 2010 and December 2023. Demographic, anthropometric, perioperative, and post-transplant data were extracted. Survival was assessed with Kaplan-Meier analysis, and Cox regression was used to explore associations with mortality.
Results:
Twenty-eight recipients underwent transplantation, predominantly bilateral sequential procedures, at a median age of 16 years. All recipients were adolescents, and cystic fibrosis (CF) was the most common indication. Severe undernutrition was common, with 64.3% meeting failure-to-thrive criteria (< 1st centile for weight) and 71.4% below the 3rd centile. Intraoperative extracorporeal membrane oxygenation replaced cardiopulmonary bypass after 2016. One-year survival was 96.4%, and median post-transplant survival was 6.8 years. Survival did not differ significantly by intraoperative extracorporeal support, but median survival was shorter in CF than in non-CF recipients (2.9 vs. 8.9 years). Hypertension developed in 53.5% of patients, diabetes in 28.5%, and acute kidney injury in 46.4%. In age- and sex-adjusted Cox models, CF, longer waiting time, Pseudomonas aeruginosa colonization, and diabetes at 1 year were associated with mortality.
Conclusion:
Pediatric lung transplantation in this cohort achieved excellent short-term survival but substantial long-term morbidity. Mortality associations should be interpreted cautiously, given the small sample size and event count. The shorter survival observed in CF recipients warrants further study, particularly in the context of severe undernutrition and chronic airway colonization.
