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Review
. 2022 Apr;36(4):e14634.
doi: 10.1111/ctr.14634. Epub 2022 Mar 10.

The changing landscape of pediatric lung transplantation

Nicholas Avdimiretz  1 , Christian Benden  2
Affiliations
Review

The changing landscape of pediatric lung transplantation

Nicholas Avdimiretz et al. Clin Transplant. 2022 Apr.

Abstract

There has been a shift over decades in the diagnostic indications for lung transplantation in children; in particular, there has been a reduction in the proportion of pediatric cystic fibrosis (CF) patients undergoing lung transplantation early in life, and more transplants occurring in other diagnostic groups. Here, we examine trends in pediatric lung transplantation with regards to indications by analyzing data from the United Network of Organ Sharing, the International Society for Heart and Lung Transplantation Thoracic Transplant Registry, and other sources. Over the past two years, there has been a precipitous decline in both the number of transplants due to CF and the proportion of CF cases relative to the total number of transplants, likely not solely due to the COVID-19 pandemic. In 2020, primary pulmonary arterial hypertension for the first-time surpassed CF as main indication for pediatric lung transplantation in the United States, a finding that is also reflected in international data. We discuss the effect of novel CFTR modulator therapies as a major factor leading to this shifting landscape. Based on our trending, pulmonary hypertension-related diagnoses and pediatric interstitial lung diseases are rising indications, for which we suggest adjustments of consensus guidelines around candidate selection criteria.

Keywords: CFTR modulator; COVID-19; cystic fibrosis; interstitial lung disease; lung transplantation; pediatrics; pulmonary hypertension.

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References

REFERENCES

    1. Hardy JD, Webb WR. Lung homotransplantation in man. JAMA. 1963;186:1065-1074.
    1. Mendeloff EN. The history of pediatric heart and lung transplantation. Pediatr Transplant. 2002;6(4):270-279.
    1. Hayes D Jr, Cherikh WS, Chambers DC, et al. The international thoracic organ transplant registry of the international society for heart and lung transplantation: twenty-second pediatric lung and heart-lung transplantation report-2019; focus theme: donor and recipient size match. J Heart Lung Transplant. 2019;38(10):1015-1027.
    1. Hayes D Jr, Harhay MO, Cherikh WS, et al. The international thoracic organ transplant registry of the international society for heart and lung transplantation: twenty-fourth pediatric lung transplantation report - 2021; focus on recipient characteristics. J Heart Lung Transplant. 2021;40(10):1023-1034.
    1. U.S. Transplants Performed: January 1, 1988 - September 30, 2021. OPTN Database. http://optn.transplant.hrsa.gov: United Network for Organ Sharing (UNOS); 2021.

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