Registry of the International Society for Heart and Lung Transplantation: Ninth Official Pediatric Lung and Heart-Lung Transplantation Report-2006

The overall experience for pediatric lung transplantation shows a stable number of recipients and centers during the past several years. There is a discrepancy between the age of recipients and age of donors, which is partially explained by the use of adult living donors. A previously noted shift toward increased use of tacrolimus and MMF continues, and induction immunosuppression is used in about 50% of cases, with no apparent effect on survival. There was also no difference in survival based on whether the donor was living or deceased. Single-lung transplantation continues to be associated with decreased survival as compared with double-lung procedures. For the first time, there is evidence of improved survival in the most recent era. There also appears to be an improvement in survival among infant recipients compared with adolescent recipients. Overall, however, survival has remained fairly constant since the previous report. Morbidity remains a significant issue, primarily in the form of hypertension, diabetes and renal dysfunction, although most survivors are without activity limitations. Late death and late morbidity from bronchiolitis obliterans remain challenging impediments to the long-term success of pediatric lung transplantation. The reported number of pediatric heart-lung transplant procedures is significantly lower than that of either pediatric heart or lung transplant procedures, and survival after this procedure is also significantly lower, particularly in infants. The causes of death are similar to those seen in lung transplantation.