Pediatric heart-lung transplantation: A contemporary analysis of outcomes.


BACKGROUND:Pediatric heart-lung transplantation (HLT) is rare, and no report has analyzed patient outcomes since time of listing. We analyzed pediatric HLTs to understand risk factors for waitlist and post-HLT mortality. METHODS:All pediatric (<18 year old) HLT candidates were identified within the UNOS database (n = 573) and grouped by age, era, and by diagnosis. Logistical regression and Cox proportional hazard modeling identified risk factors for 6-month WL and overall post-transplant mortality. RESULTS:209/573 (37%) HLT candidates were transplanted, 7% recovered, 42% died waiting, and 15% were removed for another/unknown reason. Diagnoses were primary pulmonary hypertension(n = 130), congenital heart disease(CHD) without Eisenmenger's syndrome (ES) (n = 65), CHD with ES (n = 73), and other (n = 305). Patients with a diagnosis other than CHD with ES (OR: 7.55, P = .001), on IV inotropic support (OR: 2.79, P < .001), and infants (OR: 2.20, P = .004) were associated with waitlist mortality. There has been a 56% reduction in HLTs across eras (Era 1:10.8/yr vs Era 2:4.7/yr). Risk factors for post-transplant mortality were ECMO (HR: 4.1, P = .016), and being infant (HR: 2.2, P = .04) or 1-11 years old (HR: 1.78, P = .015). ECMO patients have an 87% 2-year mortality rate with a median post-transplant survival of 64 days. Overall, post-transplant survival was unchanged (log-rank P = .067) between eras. Excluding ECMO patients, in the recent era 29 non-infant patients with primary pulmonary hypertension had 93% 1-year survival and 67% 5-year survival. CONCLUSIONS:Nearly 600 pediatric patients have been listed for HLT in UNOS, although numbers are decreasing in the current era. HLT for a patient on ECMO appears to be an ineffective strategy; however, in well-selected cohorts, HLT can provide considerable post-transplant survival.


Pediatr Transplant


Riggs KW,Chapman JL,Schecter M,Towe C,Zafar F,Morales DLS




Has Abstract


2020-05-01 00:00:00












  • Sodium ferric gluconate for post-transplant anemia in pediatric and young adult renal transplant recipients.

    abstract::Post-transplant anemia is a widespread problem among pediatric renal transplant recipients. Many clinicians treat post-transplant anemia in a manner similar to treatment of anemia in dialysis patients, including the use of intravenous iron, such as sodium ferric gluconate (SFG). Data on pediatric dosing of SFG are lim...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Gillespie RS,Symons JM

    更新日期:2005-02-01 00:00:00

  • A case of Chediak-Higashi syndrome presented with accelerated phase could be treated effectively by unrelated cord blood transplantation.

    abstract::CHS is a rare immunodeficiency syndrome with defects in the functions of cytotoxic cells and neutrophils. Approximately 85% of patients with CHS undergo an AP within the first decade, which is similar to FHLH. Chemotherapy could induce transient remission, but only allogeneic HCT could correct the underlying genetic d...

    journal_title:Pediatric transplantation



    authors: Zhang Y,Gao Z,Yu X

    更新日期:2017-11-01 00:00:00

  • ABPM vs office blood pressure to define blood pressure control in treated hypertensive paediatric renal transplant recipients.

    abstract::While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplant...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Ferraris JR,Ghezzi L,Waisman G,Krmar RT

    更新日期:2007-02-01 00:00:00

  • Potential influence of tacrolimus and steroid avoidance on early graft function in pediatric renal transplantation.

    abstract::With the increasing adoption of steroid-sparing immunosuppression protocols in renal transplantation, it is important to evaluate any adverse effects of steroid avoidance on graft function. Early graft function, measured by CrCl was retrospectively studied in 158 consecutive pediatric renal transplant recipients from ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Li L,Weintraub L,Concepcion W,Martin JP,Miller K,Salvatierra O,Sarwal MM

    更新日期:2008-09-01 00:00:00

  • Neuroradiologic findings in children with renal transplantation under 5 years of age.

    abstract::Chronic renal failure (CRF) is known to have adverse effects on the neurodevelopmental outcome of affected children. Some of these effects can be ameliorated by transplantation (TX). The cause and nature of the underlying brain injury is not known. We performed a brain magnetic resonance imaging (MRI) study on a group...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Valanne L,Qvist E,Jalanko H,Holmberg C,Pihko H

    更新日期:2004-02-01 00:00:00

  • Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care.

    abstract::The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,评审


    authors: Anthony SJ,Annunziato RA,Fairey E,Kelly VL,So S,Wray J

    更新日期:2014-08-01 00:00:00

  • Non-adherence in pediatric liver transplant recipients--an assessment of risk factors and natural history.

    abstract::Despite the fact that non-adherence to medical therapy is one of the major causes of late morbidity and mortality in pediatric liver transplant recipients, little is known of the risk factors involved in this behavior. Three cases of fatal non-adherence are reported. Factors associated with non-adherence were investig...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Lurie S,Shemesh E,Sheiner PA,Emre S,Tindle HL,Melchionna L,Shneider BL

    更新日期:2000-08-01 00:00:00

  • Resistance to growth hormone in children with chronic liver disease.

    abstract::Malnutrition adversely affects mortality and morbidity before and after liver transplantation. Outcome might be improved if liver transplant recipients were in a better nutritional state at the time of transplantation. In this review, we will examine the potential use of GH and IGF-I to improve nutritional status in p...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,评审


    authors: Bucuvalas JC,Horn JA,Chernausek SD

    更新日期:1997-08-01 00:00:00

  • Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy.

    abstract::OM is a painful inflammatory condition of the oral mucosa, derived from the toxic effects of chemotherapy and radiotherapy. High OM severity is frequently present in HSCT pediatric patients, who exhibit multiple painful ulcers that limit their mastication and swallowing, leading to poor nutritional status. Few studies...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Eduardo Fde P,Bezinelli LM,de Carvalho DL,Lopes RM,Fernandes JF,Brumatti M,Vince CS,de Azambuja AM,Vogel C,Hamerschlak N,Correa L

    更新日期:2015-05-01 00:00:00

  • Small bowel transplantation in children.

    abstract::Small bowel transplantation has become a life-saving procedure for selected adults and children with intestinal failure who are intolerant to parental nutrition. There are few pediatric data available on the results of this procedure. In this article we review the background of intestinal transplantation, present the ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,多中心研究


    authors: Atkison P,Chatzipetrou M,Tsaroucha A,Lehmann R,Tzakis A,Grant D

    更新日期:1997-11-01 00:00:00

  • Surveillance transbronchial biopsies in infant lung and heart-lung transplant recipients.

    abstract::There are limited published data on surveillance TBB for the identification of allograft rejection in infants after lung or heart-lung transplantation. We performed a retrospective review of children under one yr of age who underwent lung or heart-lung transplant at our institution. Since 2005, four infants were trans...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Hayes D Jr,Baker PB,Kopp BT,Kirkby S,Galantowicz M,McConnell PI,Astor TL

    更新日期:2013-11-01 00:00:00

  • The significance of a defect on DMSA scan in children with renal transplants.

    abstract::Since December 1995, pediatric renal transplant recipients in our unit have received a DMSA scan as soon as possible post-transplant in order to provide a baseline for comparison in the event of subsequent complications. We retrospectively reviewed the case notes and DMSA scans of the 45 patients who underwent a scan ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Hutchinson C,Beckett M,Kiratli P,Gordon I,Trompeter RS,Rees L

    更新日期:2003-12-01 00:00:00

  • Health-related quality of life changes following renal transplantation in children.

    abstract:BACKGROUND:Studies of HRQoL after kidney transplant have yielded conflicting results. We sought to assess the impact of kidney transplant on HRQoL. METHODS:We performed a retrospective study using the PedsQL3.0ESRD module during dialysis and at 3 and 12 months following kidney transplant in 56 recipients. For the enti...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Wightman A,Bradford MC,Smith J

    更新日期:2019-03-01 00:00:00

  • Diagnostic disagreement between clinical standard histopathological- and retrospective assessment of histopathology-based gastrointestinal graft-versus-host disease in children.

    abstract:BACKGROUND:No previous paediatric study has evaluated the frequency of diagnostic disagreement between clinical standard histopathological assessment (CSHA) and retrospective, independent, histopathological assessment (RIHA) of gastrointestinal Graft-Versus-Host Disease (GI-GVHD) METHODS: In a retrospective cohort stud...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Mårtensson T,Szakos A,Mellgren K,Toporski J,Arvidson J,Mattsson J,Gustafsson B,Casswall TH

    更新日期:2020-12-01 00:00:00

  • Cannulation of the aorta in organ donors with aortic and caval injuries at the time of procurement.

    abstract::Injuries sustained by major vessels during procurement pose a major threat to organ viability. Aortic and inferior vena cava lacerations produce rapid hemorrhage associated with hypoperfusion and ischemic damage. We describe a technique that will prevent such damage in the event of vascular mishaps. ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Molmenti EP,Molmenti H,Marubashi S,Sanchez EQ,Gogel B,Goldstein RM,Levy MF,Fasola CG,Gonwa TA,Klintmalm GB

    更新日期:2001-10-01 00:00:00

  • Should we retransplant a patient who is non-adherent? A literature review and critical reflection.

    abstract::The majority of transplant centers around the world face an ethical debate whether to retransplant a young non-adherent patient. Non-adherence to lifelong immunosuppressants presents a significant risk for graft loss, yet rates remain consistently high. Despite a number of these patients presenting for retransplantati...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,评审


    authors: Dobbels F,Hames A,Aujoulat I,Heaton N,Samyn M

    更新日期:2012-02-01 00:00:00

  • Pediatric renal transplantation in Turkey: a review of 56 cases from a single center.

    abstract::In order to assess certain aspects of pediatric kidney transplantation (Tx) in Turkey, we retrospectively analyzed the results of 56 of these pediatric procedures performed at our center. From January 1986 to January 1998, 56 pediatric renal Tx (29 males, 27 females; 0-17 yr of age) were carried out at Başkent Univers...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Haberal M,Bereket G,Karakayali H,Arslan G,Moray G,Bilgin N

    更新日期:2000-11-01 00:00:00

  • Functional capacity after pediatric liver transplantation: a pilot study.

    abstract::The prospective cross-sectional study investigated the 6MWT performance in pediatric group of liver transplant recipients (6-17 yr, median post-transplantation time of 22 months) and compared to the normal values obtained in healthy children as well as evaluated the reproducibility of the 6MWT. We analyzed the relatio...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Maria da Silva R,Brunow de Carvalho W,Johnston C,Borba de Castro M,Manta Ferreira I,Patti CL,Anthero de Azevedo R,Miziara Gonzalez A,Moura Linhares M,Augusto Salzedas-Netto A

    更新日期:2014-09-01 00:00:00

  • Transplantation in pediatric aHUS within the era of eculizumab therapy.

    abstract::aHUS is caused by the over-activation and dysregulation of the alternative complement pathway. Data regarding outcomes of pediatric aHUS patients after kidney transplantation are still very scarce. Accordingly, the aim of this study was to describe the clinical findings and outcomes of pediatric aHUS patients after re...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Özçakar ZB,Ozaltin F,Gülhan B,Çomak E,Parmaksız G,Baskın E,Topaloğlu R,Kasap Demir B,Canpolat N,Yuruk Yildirim Z,Demircioğlu Kılıç B,Yüksel S,Söylemezoğlu O

    更新日期:2020-11-20 00:00:00

  • Outcome of allogeneic hematopoietic stem cell transplantation for children with acute myelogenous leukemia in second complete remission: single center experience.

    abstract::We reviewed 26 consecutive patients with AML who were transplanted in second CR2 between 1994 and 2005. The most common conditioning regimen was CY and TBI. Median age at transplant was 8.9 yr (range 2.2-18.2). Nine patients received related donor, 16 patients received unrelated donors, and one patient received unrela...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Ishaqi MK,Afzal S,Dupuis A,Doyle J,Gassas A

    更新日期:2009-12-01 00:00:00

  • A systematic review of immunosuppressant adherence interventions in transplant recipients: Decoding the streetlight effect.

    abstract::Non-adherence to immunosuppressant medications is an important risk factor for graft dysfunction. To evaluate the effectiveness of adherence-enhancing interventions, we reviewed adherence intervention studies in solid organ transplant recipients (all ages). Using the following databases: PsycINFO, PubMed, Scopus, and ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,评审


    authors: Duncan S,Annunziato RA,Dunphy C,LaPointe Rudow D,Shneider BL,Shemesh E

    更新日期:2018-02-01 00:00:00

  • Predictive value of pretransplantation cyclosporine pharmacokinetic studies on initial post-transplantation dosing in pediatric kidney allograft recipients.

    abstract::Despite the introduction of a variety of new immunosuppressive agents, cyclosporine A (CsA) has maintained a strong position in pediatric transplantation (Tx). Post-Tx dosing with CsA is a challenging task because of the narrow therapeutic window of the drug, the great individual variability of metabolism and the lack...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Seikku P,Hoppu K,Jalanko H,Holmberg C

    更新日期:2003-04-01 00:00:00

  • Liver transplantation in a child with multifocal hepatocellular carcinoma hepatitis C and management of post-transplant viral recurrence using boceprevir.

    abstract::HCV infection is the leading cause of liver transplantation in the adult population in the United States. HCV infection occurs in 0.2-0.4% of the pediatric population and progression to HCC is uncommon. Liver transplantation for HCV in children is rare. In this report, we present a case of pediatric patient with HCV a...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Malik S,Dekio F,Wen JW

    更新日期:2014-03-01 00:00:00

  • Variation in resource utilization in liver transplantation at freestanding children's hospitals.

    abstract::We sought to examine the relationship between liver transplant-related total cost, patient outcome, and hospital resource utilization at freestanding children's hospitals. Using the PHIS database, a retrospective study of 374 patients that underwent liver transplantation at 15 freestanding children's hospitals from Ju...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Minneman JA,Grijalva JL,LaQuaglia MJ,Kim HB,Rangel SJ,Vakili K

    更新日期:2016-11-01 00:00:00

  • Heart transplantation in children: indications. Report of the Ad Hoc Subcommittee of the Pediatric Committee of the American Society of Transplantation (AST).

    abstract::This review details the indications for heart transplantation in children. Contraindications have evolved from absolute to relative. Controversial issues remain and this paper represents a consensus of more than a dozen centers that have programs that remain active performing pediatric heart transplants. ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章,评审


    authors: Fricker FJ,Addonizio L,Bernstein D,Boucek M,Boucek R,Canter C,Chinnock R,Chin C,Kichuk M,Lamour J,Pietra B,Morrow R,Rotundo K,Shaddy R,Schuette EP,Schowengerdt KO,Sondheimer H,Webber S

    更新日期:1999-11-01 00:00:00

  • Impact of pretransplant splenectomy on patients with beta-thalassemia major undergoing a matched-related allogeneic stem cell transplantation.

    abstract::Impact of pretransplant splenectomy in patients with beta-thalassemia major undergoing an allogeneic SCT has never been addressed. Twenty-seven class III patients (29 transplants) had a pretransplant splenectomy. The outcome of these 29 transplants was compared with 76 transplants in class III who did not have a splen...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Mathews V,George B,Lakshmi KM,Viswabandya A,John JM,Sitaram U,Daniel D,Chandy M,Srivastava A

    更新日期:2009-03-01 00:00:00

  • New-onset diabetes mellitus presenting with diabetic ketoacidosis after pediatric liver transplantation.

    abstract::The development of NODM is a common metabolic complication after liver transplantation. Presentation of post-liver transplant diabetes mellitus with DKA is rare especially among pediatric patients. We reported three pediatric patients who presented with DKA after liver transplantation. The underlying diseases leading ...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Dehghani SM,Nikeghbalian S,Eshraghian A,Haghighat M,Imanieh MH,Bahador A,Kazemi K,Malek-Hosseini SA

    更新日期:2009-08-01 00:00:00

  • Antibody response to vaccination after haematopoietic cell transplantation in children using a reduced dose schedule-A retrospective cohort study.

    abstract::Children receiving HCT loose protective immunity to vaccines received pre-HCT. Therefore, revaccination post-HCT is of major importance. In Denmark, a vaccination schedule with fewer doses post-HCT has been used, including two doses for diphtheria, tetanus, polio, measles, mumps, and rubella, and one dose only for Hae...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Jensen L,Poulsen A,Nygaard U,Scheike T,Riis MS,Pedersen FK,Heilmann C

    更新日期:2020-02-01 00:00:00

  • Mycophenolate mofetil in pediatric renal transplantation: a single center experience.

    abstract::We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the per...

    journal_title:Pediatric transplantation

    pub_type: 杂志文章


    authors: Raheem OA,Kamel MH,Daly PJ,Mohan P,Little DM,Awan A,Hickey DP

    更新日期:2011-05-01 00:00:00

  • Use of intravenous immunoglobulin in a highly sensitized pediatric renal transplant recipient with severe BK DNAemia and rising DSA.

    abstract::BK DNAemia in renal transplant recipients is a significant cause of allograft dysfunction and can lead to graft loss due to BK polyomavirus-associated nephropathy or to graft rejection due to immunosuppression reduction. Currently, the first-line treatment for BK DNAemia is immunosuppression reduction. Second-line tre...

    journal_title:Pediatric transplantation



    authors: Piburn KH,Al-Akash S

    更新日期:2020-02-01 00:00:00