Unidad de Neumología Pediátrica y Fibrosis Quística, Hospital Universitari Vall d'Hebron, Barcelona, España; Departament de Pediatria, d'Obstetricia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España.
Arch Bronconeumol. 2013 Dec;49(12):523-8. doi: 10.1016/j.arbres.2013.09.006. Epub 2013 Nov 12.
Lung transplantation has become in recent years a therapeutic option for infantswith terminal lung disease with similar results to transplantation in adults.In Spain, since 1996 114 children lung transplants have been performed; this corresponds to3.9% of the total transplant number.The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications areinterstitial lung disease and pulmonary hypertension.In most children a sequential double lung transplant is performed, generally with the help ofextracorporeal circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections .After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation.According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%.
近年来，肺移植已成为治疗终末期肺部疾病患儿的一种治疗选择，其效果与成人移植相当。在西班牙，自 1996 年以来已进行了 114 例儿童肺移植；这相当于总移植数量的 3.9%。儿童最常见的适应证是囊性纤维化，占青少年接受的移植的 70-80%。在婴儿中，常见的适应证是间质性肺病和肺动脉高压。大多数儿童接受序贯双肺移植，通常在体外循环的帮助下进行。儿童肺移植在监测和随访方面存在特殊挑战，尤其是在婴儿中，因为评估肺功能和进行经支气管活检存在困难。儿童还存在一些更具体的并发症，如移植后淋巴组织增生综合征或呼吸道病毒感染的严重程度更高。肺移植后，儿童的生活质量通常会有很大的提高。88%的儿童在移植后 3 年内活动不受限制。根据国际心肺移植学会（ISHLT）的登记，移植后 5 年的生存率为 54%，10 年生存率约为 35%。
