The influence of retransplantation on survival for pediatric lung transplant recipients.
J Thorac Cardiovasc Surg
; 156(5): 2025-2034.e2, 2018 11.
Article
in En
| MEDLINE
| ID: mdl-30343700
ABSTRACT
OBJECTIVES:
We reviewed our 25-year experience in pediatric lung transplantation with the aim to identify trends and influencing factors over time.METHODS:
We reviewed our prospectively maintained database and analyzed all patients younger than age 18 years who underwent primary lung transplantation at Medical University of Vienna between 1990 and 2015.RESULTS:
Eighty-six consecutive patients were enrolled with a mean age of 12.9 ± 4.1 years at primary transplantation. The most frequent indication for primary transplantation was cystic fibrosis (64.0). Bilateral double-lung transplantation was performed in 84 patients (97.7%), including lobar transplantation in 35 patients (40.7%). sixty-eight patients (79.1%) underwent transplant on venoarterial extracorporeal membrane oxygenation and 7 patients (8.1%) utilized cardiopulmonary bypass. The 30-day and in-hospital mortality was 8.1% and 17.4%, respectively, and 1-, 5-, and 10-year overall survival (OS) was 79.0%, 67.5%, and 57.1%, respectively. A significant improvement of OS was observed during the second treatment period after 2003 with a 1-, 5-, and 10-year OS of 86.0%, 73.9%, and 73.9%, respectively (P < .01). Seventeen retransplantations were performed in 14 patients. Twelve patients (85.7%) underwent 15 late elective retransplantations for chronic lung allograft dysfunction resulting in a 1- and 5-year OS of 91.7% and 80.2%, respectively. In contrast, 2 patients (14.3%) who underwent acute retransplantation for primary graft failure died during the postoperative period.CONCLUSIONS:
Our outcomes for pediatric lung transplantation have improved over the past 25 years and have become comparable to those for adult transplantation. Elective re-transplantations for pediatric patients were performed successfully, and strongly influenced improved long-term OS.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Reoperation
/
Lung Transplantation
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
J Thorac Cardiovasc Surg
Year:
2018
Document type:
Article
Affiliation country:
Japón