Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;21(6):597-612.
doi: 10.1007/s12519-025-00916-4. Epub 2025 Jun 3.

Pediatric lung transplantation in China, 2019-2023

Xiao-Shan Li  1   2 , Zi-Tao Wang  1 , Bo Wu  1 , Shu-Gao Ye  1 , Feng Liu  1 , Chun-Xiao Hu  2   3 , Yi Lu  1   2 , Wen-Jie Hua  1   4 , Wei-Wei Xu  1   2 , Man Huang  5   6 , Jing-Yu Chen  7   8   9   10   11
Affiliations

Pediatric lung transplantation in China, 2019-2023

Xiao-Shan Li et al. World J Pediatr. 2025 Jun.

Abstract

Background: Pediatric lung transplant (pLTX) is a rare procedure globally; its characteristics and survival outcomes in China remain unknown.

Methods: This retrospective study analyzed data from pLTX recipients aged ≤ 17 years between January 2019 and December 2023 from the China Lung Transplantation Registry. Pre-, intra-, and post-operative characteristics were described and compared between children aged 2-11 years and 12-17 years and between pLTX conducted in centers with high and low transplant volumes. The Kaplan‒Meier method was used to estimate the postoperative survival rates and 95% confidence intervals (CIs). One-year postoperative survival rates were compared between pediatric and adult lung transplant (LTX) patients via log-rank tests.

Results: Between 2019 and 2023, 63 transplants were performed in 62 pediatric patients, accounting for 1.8% of the total LTX in China. The primary indication for pLTX was bronchiolitis obliterans syndrome (46.0%), followed by cystic fibrosis (12.7%) and idiopathic pulmonary arterial hypertension (11.1%). Infection was the most common complication after pLTX (63.9%), and the incidence of bronchial anastomotic stenosis was slightly higher among recipients aged 2-11 years than among those aged 12-17 years (14.3% vs. 2.9%, P = 0.244). High-volume hospitals had a higher incidence of infections (72.7% vs. 41.2%, P = 0.021) and primary graft failure (20.0% vs. 5.9%, P = 0.260) among pediatric recipients. However, acute rejection was exclusively observed in low-volume hospitals (0.0% vs. 17.6%, P = 0.018). The in-hospital mortality rate was 16.1% (95% CI = 6.7-25.5). The 30-day and one-year survival rates after pLTX were 93.5% (95% CI = 87.6-99.9) and 80.6% (95% CI = 71.4-91.1), respectively, and were significantly higher than those of adult recipients (82.0% and 58.7%, all P < 0.05).

Conclusions: This research identified the trends, indications, donor and recipient characteristics, and complications of pLTX in China. Despite its small size, pLTX is growing gradually and has favorable outcomes. Future research on the long-term follow-up of pLTX recipients is needed to identify factors associated with the prognosis of pLTX patients.

Keywords: Indication; Lung transplantation in China; Pediatric lung transplantation; Survival.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: This study was approved by the Medical Ethics Committee of the Affiliated Wuxi People’s Hospital of Nanjing Medical University (approval number: KY25014). As this was a retrospective secondary data analysis of de-identified data, this study was exempt from ethical approval and informed consent from patients. All procedures involving human participants complied with the ethical principles outlined in the Declaration of Helsinki (as revised in 2013). Conflict of interest: No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Number of pediatric and adult lung transplants in China from 2019–2023
Fig. 2
Fig. 2
Distribution of indications for pediatric lung transplantation cases in China from January 2019 to December 2023. PH pulmonary hypertension IPAH idiopathic pulmonary arterial hypertension
Fig. 3
Fig. 3
Incidence of postoperative complications in pediatric lung transplant recipients in China from 2019–2023. a Comparison by age group; b comparison by lung transplant volume
Fig. 4
Fig. 4
Comparison of one-year postoperative survival rates between pediatric and adult lung transplantation patients
Fig. 5
Fig. 5
Causes of graft death among 17 pediatric recipients during follow-up
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Chambers DC, Perch M, Zuckermann A, Cherikh WS, Harhay MO, Hayes D Jr, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-eighth adult lung transplantation report—2021; focus on recipient characteristics. J Heart Lung Transplant. 2021;40:1060–72. - PMC - PubMed
    1. Wu B, Hu C, Chen W, He J, Jiang G, Zhang J, et al. China lung transplantation developing: past, present and future. Ann Transl Med. 2020;8:41. - PMC - PubMed
    1. Singh TP, Cherikh WS, Hsich E, Harhay MO, Hayes D Jr, Perch M, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: twenty-fifth pediatric heart transplantation report—2022; focus on infant heart transplantation. J Heart Lung Transplant. 2022;41:1357–65. - PMC - PubMed
    1. Yue B, Wu B, Zhang J, Xu H, Wei D, Hu C, et al. Pediatric lung transplantation in the largest lung transplantation center of China: embarking on a long road. Sci Rep. 2020;10:12471. - PMC - PubMed
    1. Medical Emergency Department of National Health Commission of the People’s Republic of China. Notice of the National Health Commission on issuing the “Regulations on the registration and administration of human organ transplantation diagnosis and treatment subjects”. http://www.nhc.gov.cn/ylyjs/pqt/202405/5102d68c35de488986ee889f3aa3d1bc..... Accessed 20 Jan 2025.

Publication types

LinkOut - more resources