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Transplantation |

Pediatric Lung Transplantation in the Last 20 Years in Our Hospital

José González García, MD; Sebastian Peñafiel, MD; Eugenia Libreros Niño, MD; Diana Baquero Velandia, MD; Carlos Jordá Aragón, MD; Victor Calvo Medina, PhD; Gabriel Sales Badia, PhD; Juan Escrivá, MD; Ángel García Zarza, MD; Juan Pastor Guillem, PhD
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La Fe University Hospital, Valencia, Spain


Chest. 2014;145(3_MeetingAbstracts):636A. doi:10.1378/chest.1824806
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Abstract

SESSION TITLE: Transplantation Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Share our experience in pediatric lung transplantation, survival rates and analyze the results in comparison to worldwide experience.

METHODS: Thirtytwo pediatric patients were listed for lung transplantation at our hospital from 1995 to 2013, from which 23 patients had a single-lung, bipulmonary or heart-lung transplantation. The ages were between 8 and 15 years, 12 girls and 11 boys, with a diagnosis of cystic fibrosis in 21 cases and primary pulmonary hypertension in two of them. We analyzed them retrospectively, with a Kaplan-Meier survival curve.

RESULTS: Nine patients died on the waiting list. The immediate postoperative mortality rate was cero. Survival at one, five and ten years was 86.4% (+/- 0,73),, 76.8% (+/- 0,91) and 43.4% (+/- 1,42) respectively. Median survival rate was 10.31 (+/- 1.66) years. Bipulmonary survival rates at one, five and ten years were 85% (+/- 0.8), 74.4% (+/- 0.1) and 45.3% (+/- 0.15) respectively. Heart-lung transplantation survival could not be evaluated. One bilobar-bipulmonary transplantation was performed.

CONCLUSIONS: Our results are very similar to worldwide experience. There is a very high mortality in the waiting list of the pediatric candidates for lung transplantation. This can be explained because of the lack of adecuate donors for population at pediatric age. The remarkable low mortality rate on the immediate postoperatory period can be explained by the strenght and good recovery capability that characterizes pediatric population. We found no difference in the results when doing a lobar transplantation instead of a normal bipulmonary transplant, in the case of an emergency, rather than the immediate postoperatory management.

CLINICAL IMPLICATIONS: The high mortality rate showed in the waiting list for this age population leads us to think in different ways of increasing the number of available organs. There are several ways described to do so, and we must make an effort to be able to offer them to our patients. Lobar transplantation is one of them and in our experience, even if it's a short one, can be a good example.

DISCLOSURE: The following authors have nothing to disclose: José González García, Sebastian Peñafiel, Eugenia Libreros Niño, Diana Baquero Velandia, Carlos Jordá Aragón, Victor Calvo Medina, Gabriel Sales Badia, Juan Escrivá, Ángel García Zarza, Juan Pastor Guillem

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