Kurland G
Division of Pediatric Pulmonology, University of Pittsburgh School of Medicine, PA 15213, USA.
Semin Thorac Cardiovasc Surg. 1996 Jul;8(3):277-85.
As the practice of lung transplantation in children evolves, the indications are expanding. The major diagnostic groups for which transplantation is offered are similar to those used in adult lung transplantation with the notable absence of obstructive lung disease. Of all children under the age of 18 years undergoing lung transplantation, cystic fibrosis accounts for approximately 35%, pulmonary vascular disease, with or without associated congenital heart disease, accounts for 25-30%, and interstitial lung diseases comprise about 10%. The other categories included retransplantation and a variety of diagnoses which by themselves describe an unusual form of end-stage pulmonary disease. The selection of candidates with transplantable diagnoses is crucial, and as this specialty evolves the contraindications have as well. Colonization of the airway with resistant bacterial or fungal organisms, history of multiple prior thoracic procedures, need for mechanical ventilation, diabetes mellitus, and the presence of other organ failure constitute some relative contraindications for transplantation. Retransplantation is a controversial issue that has not yet been resolved.
随着儿童肺移植实践的发展，其适应证正在不断扩大。提供移植的主要诊断类别与成人肺移植相似，但明显没有阻塞性肺疾病。在所有接受肺移植的18岁以下儿童中，囊性纤维化约占35%，有或无相关先天性心脏病的肺血管疾病占25% - 30%，间质性肺疾病约占10%。其他类别包括再次移植以及各种本身描述了一种不寻常终末期肺病形式的诊断。选择具有可移植诊断的候选人至关重要，并且随着这一专业的发展，禁忌证也在变化。气道被耐药细菌或真菌定植、既往多次胸部手术史、需要机械通气、糖尿病以及存在其他器官衰竭构成了一些移植的相对禁忌证。再次移植是一个尚未解决的有争议的问题。
