PMID- 33210834
OWN - NLM
STAT- MEDLINE
DCOM- 20210802
LR  - 20211204
IS  - 1099-0496 (Electronic)
IS  - 1099-0496 (Linking)
VI  - 56
IP  - 3
DP  - 2021 Mar
TI  - Lung transplantation as an intervention for pediatric pulmonary hypertension.
PG  - 587-592
LID - 10.1002/ppul.25154 [doi]
AB  - Lung transplantation is a treatment option for selected children with end-stage 
      lung disease and pulmonary vascular disorders. Overall, pulmonary hypertension 
      (PH) is the second most frequent indication for infants and children requiring 
      lung transplants. In pediatric PH patients, timing for listing remains a 
      difficult decision due to patient heterogeneity and varying allocation policies 
      across different countries. Furthermore, perioperative management can be 
      challenging, making interdisciplinary collaboration among surgical, 
      anesthesiology, critical care, and lung transplant teams essential. Because 
      pediatric PH patients typically have preserved cardiac index and exercise 
      tolerance even with advanced disease, they should be referred early even if they 
      do not meet the criteria for listing of primarily adults by International Society 
      for Heart and Lung Transplantation (ISHLT) published in 2015: New York Heart 
      Association (NYHA) functional class III or IV without improvement, cardiac 
      index < 2 L/min/m(2) , mean right atrial pressure of >15 mmHg. Bridging 
      strategies with extracorporeal support should be determined at the time of 
      listing in anticipation of possible clinical deterioration. Bilateral lung 
      transplantation using cardiopulmonary bypass to provide hemodynamic stability is 
      nowadays the standard surgical approach in pediatric centers. The immediate 
      post-transplant period is characterized by dramatic changes in the right 
      ventricle (RV) and and left ventricle (LV) anatomy and physiology, which can be 
      life-threatening. Induction, immunosuppression, prophylaxis, and surveillance are 
      not different from patients without PH. Overall, outcomes in pediatric lung and 
      heart-lung transplant patients for PH are not different from those children 
      undergoing transplantation for other indications. In fact, long-term survival is 
      superior in children with idiopathic PH compared to other diseases, providing 
      most recipients with improved quality of life.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Melicoff, Ernestina
AU  - Melicoff E
AUID- ORCID: 0000-0001-5696-7112
AD  - Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
FAU - Hayes, Don Jr
AU  - Hayes D Jr
AUID- ORCID: 0000-0002-6734-6052
AD  - Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA.
FAU - Benden, Christian
AU  - Benden C
AD  - Faculty of Medicine, University of Zurich, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201119
PL  - United States
TA  - Pediatr Pulmonol
JT  - Pediatric pulmonology
JID - 8510590
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Echocardiography
MH  - Exercise Test
MH  - Familial Primary Pulmonary Hypertension/*surgery
MH  - Heart Transplantation/adverse effects/methods
MH  - Heart Ventricles
MH  - Humans
MH  - Immunosuppression Therapy
MH  - Infant
MH  - Lung/surgery
MH  - Lung Diseases/*surgery
MH  - Lung Transplantation/adverse effects/*methods
MH  - Magnetic Resonance Imaging
MH  - Postoperative Period
MH  - Quality of Life
MH  - Symptom Assessment
MH  - Treatment Outcome
MH  - Ventricular Function
MH  - Waiting Lists
OTO - NOTNLM
OT  - children
OT  - lung transplantation
OT  - pediatric
OT  - pulmonary hypertension
EDAT- 2020/11/20 06:00
MHDA- 2021/08/03 06:00
CRDT- 2020/11/19 08:48
PHST- 2020/05/06 00:00 [received]
PHST- 2020/09/30 00:00 [revised]
PHST- 2020/10/22 00:00 [accepted]
PHST- 2020/11/20 06:00 [pubmed]
PHST- 2021/08/03 06:00 [medline]
PHST- 2020/11/19 08:48 [entrez]
AID - 10.1002/ppul.25154 [doi]
PST - ppublish
SO  - Pediatr Pulmonol. 2021 Mar;56(3):587-592. doi: 10.1002/ppul.25154. Epub 2020 Nov 
      19.