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Dominique Métras
Hani Shennib
Bernard Kreitmann
Roger Giudicelli
Michel Noirclerc
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Ann Thorac Surg 1993;55:352-357
© 1993 The Society of Thoracic Surgeons

Articles

Double-lung transplantation in children: A report of 20 cases

Dominique Métras, MD*,a,b,c, Hani Shennib, MDa,b,c, Bernard Kreitmann, MDa,b,c, Jean Camboulives, MDa,b,c, Laurent Viard, MDa,b,c, Michel Carcassonne, MDa,b,c, Roger Giudicelli, MDa,b,c, Michel Noirclerc, MDa,b,c The Joint Marseille-Montréal Lung Transplant Programa,b,c

a Hôpital Ste. Marguerite, Marseille, France
b La Timone Children's Hospital, Marseille, France
c Montréal Général Hospital, Montréal, Québec, Canada

* Address reprint requests to Dr Métras, La Timone Children's Hospital, Blvd Jean Moulin, 13385 Marseille, Cédex 5, France.

In the last [equation] years, we have performed 20 double-lung transplantations in children between 7 and 16 years old (mean age, 13 years). One patient had primitive bronchiolitis obliterans and the other 19, cystic fibrosis. Eight patients were operated on in an emergency situation, 7 of them requiring ventilator support before transplantation. The procedures were en bloc double-lung transplantation in the first 11 patients with separate bronchial anastomoses in 10, and sequential bilateral lung transplantation in the later 9 patients. There were no operative deaths. Two patients died in the hospital on postoperative days 37 and 73, and there were four late deaths, which were due to infection, rejection, and bronchiolitis obliterans. The acceptable incidence of airway complications, the improvement in lung function of survivors, and the acceptable midterm survival make double-lung transplantation an acceptable alternative to heart-lung transplantation in children. However, in very small children, heart-lung transplantation may be preferable because of the size of the airway anastomoses at risk.




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