Practical Journal of Organ Transplantation(Electronic Version) ›› 2021, Vol. 9 ›› Issue (4): 304-308.DOI: 10.3969/j.issn.2095-5332.2021.04.010

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Experience analysis of 12 pediatric lung transplantation

Liu Feng 1 ，Zhao Gaofeng 2 ，Liu Xiaofei 2 ，Jiang Huachi 1 ，Jin Yulin 1 ，Li Huixing 1 ，Huang Jian 1 ，Chen Jingyu 1
  

  1. 1. Department of Thoracic Surgery，Wuxi People's Hospital Affiliated to Nanjing Medical University，Wuxi 214023，Jiangsu，China ；

    2. Department of Thoracic Surgery，First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，Henan，China

  • Online:2021-07-20 Published:2023-04-12

儿童肺移植 12 例经验分析 

刘峰 1 ，赵高峰 2 ，刘晓飞 2 ，蒋华驰 1 ，金玉麟 1 ，李慧星 1 ，黄健 1 ，陈静瑜 1   

  1. 1. 南京医科大学附属无锡市人民医院胸外科，214023

    2.郑州大学第一附属医院胸外科， 河南 郑州 450052

  • 基金资助:

    国家自然科学基金面上项目（82070059；81870047）；

    江苏省自然基金青年基金（BK20190150；BK20160196）；

    国家自然科学基金青年基金（81500039；81901259）

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Abstract:

Objective To summarize the clinical experience of 12 children with lung transplantation. Methods We carried out a retrospective analysis on the data of 12 pediatric lung transplantation performedbetween December 2007 and August 2020，focusing on the indications，postoperative complications and survival rate. Results Twelve children underwent lung transplantation，including 5 males and 7 females. The age of patients were aged 2 to 17 years old at the time of lung transplantation（median age was 13.5 years old），and 5 cases were younger than 12 years old，accounting for 41.7%；their weight varies between 15 to 55kg（median weight was 45 kg）. According to the preoperative diagnosis，4（33.3%）had idiopathic pulmonary hypertension，3（25%） had bronchiolitis obliterans ，3（25%）had interstitial lung disease ，and 1（8.3%）had congenital heart disease and 1（8.3%）had pulmonary cystic fibrosis. The recipients all received lung grafts with identical or compatible ABO blood type. Cyclosporine or tacrolimus，mycophenolate mofetil and prednisone were applied as the immunosuppressive therapy. Postoperative complications included 10 cases of infection，3 cases of cardiac dysfunction，2 cases of primarygraft dysfunction，1 case of postoperative bleeding，and 1 case of airway stenosis. All patients recovered and were discharged after the operation. One patient died 6 months after the operation because of airway stenosis complicated with infection. Conclusion Lung transplantation is a safe and effective way to treat end-stage lung disease in children. We should pay more attention to selecting appropriate donors and recipients，standardizing operations，strengthening postoperative management and actively preventing complications in order to improve the survival rate of recipients.

Key words:

Children, Lung transplantation, End-stage lung disease

摘要：

目的 总结 12 例儿童肺移植的临床经验。方法 回顾性分析南京医科大学附属无锡市人民医院 2007 年 12 月— 2020 年 8 月实施的 12 例儿童肺移植的资料，重点对适应证、术后并发症及生存率进行分析。结果 12 例患儿行肺移植，其中男性 5 例，女性 7 例。患儿行肺移植时年龄为 2 ～ 17 岁（年龄中位数为 13.5 岁），小于 12 岁 5 例，占比 41.7% ；体重为 15 ～ 55 kg（体重中位数为 45 kg）。术前诊断为特发性肺动脉高压 4 例（33.3%），闭塞性细支气管炎 3 例（25%），间质性肺病 3 例（25%），先天性心脏病
1 例（8.3%），肺囊性纤维化 1 例（8.3%）。受者均接受 ABO 血型相同或相容供肺。免疫抑制方案采用环孢素或他克莫司 + 吗替麦考酚酯 + 泼尼松。术后并发症，包括感染 10 例，心功能不全 3 例，原发性移植物功能障碍 2 例，术后出血 1 例，气道狭窄 1 例。患者术后均康复出院，1 例气道狭窄合并感染于术后 6 个月死亡。结论 肺移植治疗儿童终末期肺病是安全、有效的，应注意选择合适的供、受者，加强术中操作和术后的管理，积极预防并发症，以提高受者生存率。

关键词:

儿童 , 肺移植 , 终末期肺病

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