Related Experiment Video
Updated: Aug 16, 2026
Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
Published on: July 10, 2012
Ten year experience with pulmonary allografts in children
1Children's Hospital, Denver, CO 80218, USA.
Insights
Pediatric patients receiving pulmonary valve allografts for right ventricular outflow tract reconstruction showed higher rates of valve complications, especially in infants. Allografts remain a viable option when surgical repair alternatives are limited in young children.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Transplantation Immunology
Background:
- Pulmonary valve allografts are used for right ventricular outflow tract reconstruction in pediatric patients.
- Infants undergoing this procedure face higher risks of fibrocalcification and valvar insufficiency compared to older children.
Purpose of the Study:
- To evaluate the outcomes of cryopreserved pulmonary valve allografts in pediatric patients with varying age groups.
- To compare the incidence of allograft complications between infants and older children.
Main Methods:
- Retrospective analysis of 186 pediatric patients who received pulmonary valve allografts.
- Patients were divided into two groups: infants (<1 year) and older children (≥1 year).
- Clinical follow-up was conducted to assess hospital mortality, late deaths, reoperations, and explants.
Main Results:
- Infants (<1 year) had a higher hospital death rate (23%) and late death rate (29%) compared to older children (10% and 4%, respectively).
- 16% of infants required valve allograft explant, while 4% of older children needed reoperation.
- Allografts are technically desirable in small children with limited surgical repair alternatives.
Conclusions:
- Pulmonary valve allografts in infants undergoing right ventricular outflow tract reconstruction are associated with significantly higher morbidity and mortality.
- Despite risks, allografts remain a crucial option for infants when other surgical interventions are not feasible.
Abstract:
Infants who have undergone pulmonary valve allograft reconstruction of the right ventricular outflow tract experience an increased incidence of allograft fibrocalcification and valvar insufficiency compared to older allograft recipients. Since April 1985, 186 cryopreserved pulmonary valve allografts have been used for right ventricular outflow tract reconstruction in pediatric patients at The Children's Hospital and the University of Colorado Health Sciences Center in Denver. One hundred and forty-six patients were one to 18.4 years of age (mean age: 5.0 years) and 40 children were younger than one year of age at operation (mean age: 4.4 months). In the older patient group, there were 15 hospital deaths (10%) and one child with dilated cardiomyopathy and cardiac failure underwent cardiac transplantation two days postoperatively. One hundred and thirty operative survivors have been followed clinically for a mean of 4.6 years. One child was lost to follow up and one patient with myocardial dysfunction required cardiac transplant 3.8 years postoperatively. There have been five late deaths (4%), one of which resulted from accidental trauma. Five children (4%) have undergone reoperation to replace their valve allograft at 1.3 to 9.8 years after the initial allograft procedure. In the infant group, there were nine hospital deaths (23%). During follow up averaging 3.0 years, there have been nine late deaths (29%) and five children (16%) have undergone valve allograft explant 2.0 months to 3.5 years following implantation. Allografts are technically desirable in small children for whom surgical repair alternatives are limited.(ABSTRACT TRUNCATED AT 250 WORDS)
