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Bilateral single-lung transplantation in children
D Metras1, B Kreitmann, A Riberi
1Unit of Cardio-Thoracic Surgery, La Timone Children's Hospital, Marseille, France.
The Annals of Thoracic Surgery
|December 1, 1995
Summary
Bilateral single-lung transplantation is a viable option for pediatric patients, showing acceptable outcomes and satisfactory bronchial healing. This technique offers comparable midterm and long-term results to heart-lung transplants.
Area of Science:
- Pediatric surgery
- Thoracic surgery
- Transplantation medicine
Background:
- Examined experience with bilateral single-lung transplantation in pediatric patients.
- Performed 32 double-lung transplantations between 1988 and 1995.
- Shifted from en bloc to bilateral single-lung techniques for 22 patients.
Purpose of the Study:
- Evaluate the efficacy and safety of bilateral single-lung transplantation in children.
- Assess outcomes in pediatric patients with various lung diseases.
- Determine suitability of the technique for small children.
Main Methods:
- Utilized bilateral single-lung transplantation in 22 pediatric patients.
- Indications included cystic fibrosis (16), obliterative bronchiolitis (1), pulmonary artery hypertension (1), and retransplantation (4).
- Procedures involved "clam-shell" incision, normothermic cardiopulmonary bypass, and beating heart technique.
Main Results:
- One postoperative death due to heart failure in a retransplantation patient.
- Satisfactory bronchial healing observed; 3 patients required temporary stenting.
- Actuarial survival rates were 75% at 1 year, 56% at 2 years, and 36% at 3 years.
Conclusions:
- Bilateral single-lung transplantation is an acceptable technique for pediatric patients, including small children.
- Bronchial healing is satisfactory, and revascularization is not required.
- Midterm and long-term results are comparable to heart-lung transplants, presenting an adequate strategy for pediatric lung disease.