Abstract
Background
Pediatric lung transplantation is performed in highly experienced centers due to the
peculiar population characteristics. The literature is limited and not representative
of individual countries' differences. The purpose of this study was to analyze the
Italian experience.
Methods
A multicentric retrospective analysis was performed on 110 pediatric patients (<18 years
old) who underwent lung transplantation from 1992 to 2019 at 9 Italian centers. Heart–lung
transplantations and lung retransplantations were excluded.
Results
The population was composed of 44 male and 66 female patients, with a median age of
15 years. The most frequent indication was cystic fibrosis (83%). One quarter of patients
were transplanted in an emergency setting. Median donors' Oto score and age were 1
and 15 years, respectively, with 43% of adult donors. In 17% of patients a graft reduction
was performed. Postoperatively, the median duration of mechanical ventilation, intensive
care unit, and in-hospital stay were 48 hours, 11 and 35 days, respectively. Thirty-day
mortality was 6%, and 1-, 5-, and 10-year survival was 72%, 52%, and 33%, respectively.
Risk factors for mortality were Oto score and recipients' body mass index.
Conclusions
The outcomes of pediatric lung transplantation in Italy are comparable with current
literature. Particular attention should be paid to the Oto score and recipient body
mass index. Conversely, adult donors and graft reductions can be safely used to expand
the donor pool.
Graphical abstract
Graphical Abstract
Key Words
Abbreviations and Acronyms:
BMI (body mass index), CI (confidence interval), CLAD (chronic lung allograft dysfunction), CPB (cardiopulmonary bypass), ECMO (extracorporeal membrane oxygenation), FEV1 (forced expiratory volume in 1 second), HR (hazard ratio), ICU (intensive care unit), ISHLT (International Society of Heart and Lung Transplantation), IQR (interquartile range), MV (mechanical ventilation), OR (odds ratio), PGD (primary graft dysfunction), TLC (total lung capacity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 20, 2022
Accepted:
June 7,
2022
Received in revised form:
May 17,
2022
Received:
December 24,
2021
Identification
Copyright
© 2022 by The American Association for Thoracic Surgery
