Pediatric Lung Transplantation: Review of the Literature

Since the first lung transplantation in 1986, about 2000 PLT have been performed world-wide, with an annual number stable around hundred per year. Exceptional before the age of five, most lung transplantations are performed in children over 10 years old. The two most common indications are cystic fibrosis and vascular lung disease. The main difficulties of the procedure are the lack of adequate donors, resulting in lobar transplantations, and the management of bronchial complications secondary to the small caliber of the donor bronchus. Unlike liver or kidney transplantation, living donor lung transplantation is unusual because of an unacceptable risk for the donor. 1- and 5-year survival rates are 75% and 50%, respectively; similar to the survival observed in adult lung transplantation (data from the International Society Heart and Lung Transplantation). Moreover, as in the adult population, bronchiolitis obliterans is the main complication during the long term outcome. Thus, the question of retransplantation is even more important for children than for adults.