Pediatric heart-lung transplantation

Intermediate-term results

J. V. Conte, R. C. Robbins, H. Reichenspurner, V. G. Valentine, J. Theodore, B. A. Reitz

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Adult heart-lung transplantation was initiated at Stanford in 1981 and the first pediatric heart-lung transplantation was done in 1986. Intermediate-term results of pediatric heart-lung transplantation at Stanford University are presented. Methods: A retrospective review of the records of all pediatric heart-lung transplantations done since 1986 was conducted. Results: Nineteen heart-lung transplantations were done in 17 patients. Ages ranged from 2 months to 18 years with a median age of 10 years. At the time of transplantation 5 patients were infants, 7 children, and 7 adolescents. The mean follow-up was 29 ± 6.2 months (range 1 to 77, median 16) and follow-up was 100% complete. Diagnoses were congenital heart disease in 13, primary pulmonary hypertension in 2, and cystic fibrosis, cystic lymphangiectasia, viral pneumonia, and obliterative bronchiolitis in 1 each. Median wait on the heart-lung transplantation list was 91 days (range 2 to 707). All patients had New York Heart Association class III to IV symptoms, two were receiving ventilator support, and six were receiving oxygen. Fifteen of 19 transplant recipients were discharged from the hospital. The 30-day operative mortality rate was 5.2% (1 of 19). The actuarial survival at 1, 3, and 5 years for all patients was 67%, 51%, and 41%, respectively, and for hospital survivors was 82%, 62%, and 51%. The cause of death was obliterative bronchiolitis in 4, multisystem organ failure in 3, and graft coronary artery disease and chronic airway disease in 1 each. Three patients required retransplantation, 2 because of obliterative bronchiolitis and 1 because of viral pneumonia. Two patients underwent repeat heart-lung transplantation and 1 patient underwent single lung transplantation. Rejection was diagnosed in 73% of recipients, and obliterative bronchiolitis has developed in 32% of recipients. Conclusions: Survival in pediatric heart-lung transplantation approximates that in the adult procedure at 1, 3, and 5 years. Long-term survival has been achieved but the primary factors limiting further improved survival remain infection and obliterative bronchiolitis.

Original languageEnglish (US)
Pages (from-to)692-699
Number of pages8
JournalJournal of Heart and Lung Transplantation
Volume15
Issue number7
StatePublished - 1996
Externally publishedYes

Fingerprint

Heart-Lung Transplantation
Bronchiolitis
Pediatrics
Viral Pneumonia
Survival
Lymphangiectasis
Lung Transplantation
Mechanical Ventilators
Cystic Fibrosis
Survivors
Coronary Artery Disease
Cause of Death
Heart Diseases
Chronic Disease
Transplantation
Oxygen
Transplants
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

Conte, J. V., Robbins, R. C., Reichenspurner, H., Valentine, V. G., Theodore, J., & Reitz, B. A. (1996). Pediatric heart-lung transplantation: Intermediate-term results. Journal of Heart and Lung Transplantation, 15(7), 692-699.

Pediatric heart-lung transplantation : Intermediate-term results. / Conte, J. V.; Robbins, R. C.; Reichenspurner, H.; Valentine, V. G.; Theodore, J.; Reitz, B. A.

In: Journal of Heart and Lung Transplantation, Vol. 15, No. 7, 1996, p. 692-699.

Research output: Contribution to journalArticle

Conte, JV, Robbins, RC, Reichenspurner, H, Valentine, VG, Theodore, J & Reitz, BA 1996, 'Pediatric heart-lung transplantation: Intermediate-term results', Journal of Heart and Lung Transplantation, vol. 15, no. 7, pp. 692-699.
Conte JV, Robbins RC, Reichenspurner H, Valentine VG, Theodore J, Reitz BA. Pediatric heart-lung transplantation: Intermediate-term results. Journal of Heart and Lung Transplantation. 1996;15(7):692-699.
Conte, J. V. ; Robbins, R. C. ; Reichenspurner, H. ; Valentine, V. G. ; Theodore, J. ; Reitz, B. A. / Pediatric heart-lung transplantation : Intermediate-term results. In: Journal of Heart and Lung Transplantation. 1996 ; Vol. 15, No. 7. pp. 692-699.
@article{c0f16aa6c9e04039bd4fd991d62f6f41,
title = "Pediatric heart-lung transplantation: Intermediate-term results",
abstract = "Background: Adult heart-lung transplantation was initiated at Stanford in 1981 and the first pediatric heart-lung transplantation was done in 1986. Intermediate-term results of pediatric heart-lung transplantation at Stanford University are presented. Methods: A retrospective review of the records of all pediatric heart-lung transplantations done since 1986 was conducted. Results: Nineteen heart-lung transplantations were done in 17 patients. Ages ranged from 2 months to 18 years with a median age of 10 years. At the time of transplantation 5 patients were infants, 7 children, and 7 adolescents. The mean follow-up was 29 ± 6.2 months (range 1 to 77, median 16) and follow-up was 100{\%} complete. Diagnoses were congenital heart disease in 13, primary pulmonary hypertension in 2, and cystic fibrosis, cystic lymphangiectasia, viral pneumonia, and obliterative bronchiolitis in 1 each. Median wait on the heart-lung transplantation list was 91 days (range 2 to 707). All patients had New York Heart Association class III to IV symptoms, two were receiving ventilator support, and six were receiving oxygen. Fifteen of 19 transplant recipients were discharged from the hospital. The 30-day operative mortality rate was 5.2{\%} (1 of 19). The actuarial survival at 1, 3, and 5 years for all patients was 67{\%}, 51{\%}, and 41{\%}, respectively, and for hospital survivors was 82{\%}, 62{\%}, and 51{\%}. The cause of death was obliterative bronchiolitis in 4, multisystem organ failure in 3, and graft coronary artery disease and chronic airway disease in 1 each. Three patients required retransplantation, 2 because of obliterative bronchiolitis and 1 because of viral pneumonia. Two patients underwent repeat heart-lung transplantation and 1 patient underwent single lung transplantation. Rejection was diagnosed in 73{\%} of recipients, and obliterative bronchiolitis has developed in 32{\%} of recipients. Conclusions: Survival in pediatric heart-lung transplantation approximates that in the adult procedure at 1, 3, and 5 years. Long-term survival has been achieved but the primary factors limiting further improved survival remain infection and obliterative bronchiolitis.",
author = "Conte, {J. V.} and Robbins, {R. C.} and H. Reichenspurner and Valentine, {V. G.} and J. Theodore and Reitz, {B. A.}",
year = "1996",
language = "English (US)",
volume = "15",
pages = "692--699",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "7",

}

TY - JOUR

T1 - Pediatric heart-lung transplantation

T2 - Intermediate-term results

AU - Conte, J. V.

AU - Robbins, R. C.

AU - Reichenspurner, H.

AU - Valentine, V. G.

AU - Theodore, J.

AU - Reitz, B. A.

PY - 1996

Y1 - 1996

N2 - Background: Adult heart-lung transplantation was initiated at Stanford in 1981 and the first pediatric heart-lung transplantation was done in 1986. Intermediate-term results of pediatric heart-lung transplantation at Stanford University are presented. Methods: A retrospective review of the records of all pediatric heart-lung transplantations done since 1986 was conducted. Results: Nineteen heart-lung transplantations were done in 17 patients. Ages ranged from 2 months to 18 years with a median age of 10 years. At the time of transplantation 5 patients were infants, 7 children, and 7 adolescents. The mean follow-up was 29 ± 6.2 months (range 1 to 77, median 16) and follow-up was 100% complete. Diagnoses were congenital heart disease in 13, primary pulmonary hypertension in 2, and cystic fibrosis, cystic lymphangiectasia, viral pneumonia, and obliterative bronchiolitis in 1 each. Median wait on the heart-lung transplantation list was 91 days (range 2 to 707). All patients had New York Heart Association class III to IV symptoms, two were receiving ventilator support, and six were receiving oxygen. Fifteen of 19 transplant recipients were discharged from the hospital. The 30-day operative mortality rate was 5.2% (1 of 19). The actuarial survival at 1, 3, and 5 years for all patients was 67%, 51%, and 41%, respectively, and for hospital survivors was 82%, 62%, and 51%. The cause of death was obliterative bronchiolitis in 4, multisystem organ failure in 3, and graft coronary artery disease and chronic airway disease in 1 each. Three patients required retransplantation, 2 because of obliterative bronchiolitis and 1 because of viral pneumonia. Two patients underwent repeat heart-lung transplantation and 1 patient underwent single lung transplantation. Rejection was diagnosed in 73% of recipients, and obliterative bronchiolitis has developed in 32% of recipients. Conclusions: Survival in pediatric heart-lung transplantation approximates that in the adult procedure at 1, 3, and 5 years. Long-term survival has been achieved but the primary factors limiting further improved survival remain infection and obliterative bronchiolitis.

AB - Background: Adult heart-lung transplantation was initiated at Stanford in 1981 and the first pediatric heart-lung transplantation was done in 1986. Intermediate-term results of pediatric heart-lung transplantation at Stanford University are presented. Methods: A retrospective review of the records of all pediatric heart-lung transplantations done since 1986 was conducted. Results: Nineteen heart-lung transplantations were done in 17 patients. Ages ranged from 2 months to 18 years with a median age of 10 years. At the time of transplantation 5 patients were infants, 7 children, and 7 adolescents. The mean follow-up was 29 ± 6.2 months (range 1 to 77, median 16) and follow-up was 100% complete. Diagnoses were congenital heart disease in 13, primary pulmonary hypertension in 2, and cystic fibrosis, cystic lymphangiectasia, viral pneumonia, and obliterative bronchiolitis in 1 each. Median wait on the heart-lung transplantation list was 91 days (range 2 to 707). All patients had New York Heart Association class III to IV symptoms, two were receiving ventilator support, and six were receiving oxygen. Fifteen of 19 transplant recipients were discharged from the hospital. The 30-day operative mortality rate was 5.2% (1 of 19). The actuarial survival at 1, 3, and 5 years for all patients was 67%, 51%, and 41%, respectively, and for hospital survivors was 82%, 62%, and 51%. The cause of death was obliterative bronchiolitis in 4, multisystem organ failure in 3, and graft coronary artery disease and chronic airway disease in 1 each. Three patients required retransplantation, 2 because of obliterative bronchiolitis and 1 because of viral pneumonia. Two patients underwent repeat heart-lung transplantation and 1 patient underwent single lung transplantation. Rejection was diagnosed in 73% of recipients, and obliterative bronchiolitis has developed in 32% of recipients. Conclusions: Survival in pediatric heart-lung transplantation approximates that in the adult procedure at 1, 3, and 5 years. Long-term survival has been achieved but the primary factors limiting further improved survival remain infection and obliterative bronchiolitis.

UR - http://www.scopus.com/inward/record.url?scp=0029781451&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029781451&partnerID=8YFLogxK

M3 - Article

VL - 15

SP - 692

EP - 699

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 7

ER -