Survival and functional outcomes after pediatric living-donor lobar lung transplantation and deceased-donor lung transplantation: A Japanese multicenter retrospective study

IF 6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Heart and Lung Transplantation Pub Date : 2025-07-01 Epub Date: 2025-01-22 DOI:10.1016/j.healun.2025.01.012

Yuki Morimura , Kei Matsubara , Satona Tanaka , Haruki Choshi , Shin Tanaka , Takashi Kanou , Yojiro Yutaka , Akihiro Ohsumi , Daisuke Nakajima , Yasushi Shintani , Seiichiro Sugimoto , Shinichi Toyooka , Hiroshi Date

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Abstract

Background

In pediatric living-donor lobar lung transplantation, whether transplanting adult lobes could result in satisfactory long-term survival and respiratory functional outcomes during and after the growth period in pediatric patients remains unclear. This study aimed to evaluate the long-term survival and functional prognosis after pediatric living-donor lobar lung transplantation and deceased-donor lung transplantation.

Methods

We retrospectively reviewed clinical data of pediatric patients (age: ≤17 years) who underwent lung transplantation between March 2001 and December 2022 at 3 institutions in Japan.

Results

Seventy and 24 patients who underwent living-donor and deceased-donor transplantation, respectively, were included. The 5-year and 10-year overall survival rates were 84.6% and 75.0% after living-donor transplantation and 85.8% and 85.8% after deceased-donor transplantation (p = 0.75), respectively. With a median follow-up period of 89.2 months, 48 living-donor cases (100%) and 16 deceased-donor cases (84.2%) had performance status 0 to 2 among 48 living-donor cases and 19 deceased-donor cases who were alive without retransplantation. They showed height growth (median +9.7 cm, p < 0.01); however, the height standard deviation score decreased after transplantation (median −0.22, p = 0.03). The difference in height standard deviation score between the last follow-up and pretransplantation was negative (median −0.42) in living-donor cases and significantly smaller than that in deceased-donor cases (median +0.19, p = 0.02).

Conclusions

Pediatric living-donor lobar lung transplantation provided satisfactory long-term survival and functional prognosis that were comparable to those of deceased-donor lung transplantation. The limited post-transplant height growth in living-donor cases might be attributed to this favorable functional prognosis.

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儿童活体供体大叶肺移植和死亡供体肺移植后的生存和功能结局：一项日本多中心回顾性研究。

背景：在儿童活体供体肺叶移植中，成人肺叶移植是否能在儿童患者生长期间和生长后获得令人满意的长期生存和呼吸功能结果尚不清楚。本研究旨在评估儿童活体大叶肺移植和死亡供体肺移植术后的长期生存和功能预后。方法：我们回顾性回顾了2001年3月至2022年12月期间在日本三家机构接受肺移植的儿科患者（年龄≤17岁）的临床资料。结果：分别有70例和24例患者接受了活体供体移植和死亡供体移植。活体移植后的5年和10年总生存率分别为84.6%和75.0%，死供体移植后的5年和10年总生存率分别为85.8%和85.8% （p = 0.75）。中位随访89.2个月，48例活体供者（100%）、16例死亡供者（84.2%）表现为0-2，其中19例死亡供者存活且未再移植。身高显著增高（中位数+9.7 cm, p < 0.01）；然而，移植后身高标准差评分下降（中位数-0.22,p = 0.03）。活体供体患者最后一次随访与移植前的身高标准差为负（中位数-0.42），显著小于死亡供体患者（中位数+0.19,p = 0.02）。结论：儿童活体供体大叶肺移植可提供满意的长期生存和功能预后，与死亡供体肺移植相当。活体供体病例移植后身高增长有限可能归因于这种良好的功能预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.