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Paediatric lung transplantation: the impact of age on the survival

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Abstract

Objectives

We herein review the outcomes of paediatric lung transplantation (LTx) and analyse subgroups divided by age.

Methods

We retrospectively reviewed 43 consecutive paediatric LTx recipients (< 18 years old: cadaveric LTx [n = 9], living-donor lobar LTx [n = 34]). We also analysed subgroups of patients 1–6 years old (n = 10) and 7–17 years old (n = 33).

Results

The 1-, 5- and 10-year overall survival (OS) rates in paediatric recipients were 93%, 82% and 67%, respectively. The 1-, 5- and 10-year graft dysfunction (GD)-free survival rates in paediatric recipients were 85%, 59% and 31%, respectively. The 1- and 5-year OS in the 1- to 6-year-old vs. 7- to 17-year-old groups were 70% vs. 100% and 48% vs. 93%, respectively (p < 0.0001). The 1- and 5-year GD-free survival rates in the 1- to 6-year-old vs. 7- to 17-year-old groups were 60% vs. 93% and 24% vs. 69%, respectively (p = 0.024). The 1- to 6-year-old group showed higher rates of non-standard LTx (p = 0.0001), interstitial pneumonia (p = 0.004) and ventilator dependency (p = 0.007) than the 7- to 17-year-old group.

Conclusion

Paediatric recipients under 7 years old seemed to have a higher risk of mortality and GD than those 7 years old and older.

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Abbreviations

AMR:

Antibody-mediated rejection

CLAD:

Chronic lung allograft dysfunction

CLTx:

Cadaveric lung transplantation

FVC:

Forced vital capacity

GD:

Lung graft dysfunction

ISHLT:

International Society for Heart and Lung Transplantation

LAS:

Lung allocation score

LDLLTx:

Living-donor lobar lung transplantation

LTx:

Lung transplantation

OS:

Overall survival

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Funding

This work was supported by a Grant-in-Aid for Scientific Research (20K09176) from the Japan Society for the Promotion of Science.

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Author notes

  1. Shinji Otani

    Present address: Department of Cardiovascular and Thoracic Surgery, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan

Authors and Affiliations

  1. Department of General Thoracic Surgery/Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Shinji Otani, Shin Tanaka, Yasuaki Tomioka, Kei Matsubara, Dai Shimizu, Toshio Shiotani, Ken Suzawa, Kentaroh Miyoshi, Hiromasa Yamamoto, Mikio Okazaki, Seiichiro Sugimoto, Masaomi Yamane & Shinichi Toyooka

  2. Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada

    Haruchika Yamamoto

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  1. Shinji Otani
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Correspondence to Shinji Otani.

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Otani, S., Yamamoto, H., Tanaka, S. et al. Paediatric lung transplantation: the impact of age on the survival. Surg Today 52, 1540–1550 (2022). https://doi.org/10.1007/s00595-022-02492-w

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