Functional, Volumetric, and Growth Outcomes After Pediatric Bilateral Lung Transplantation
Seon Yong Bae, Samina Park, Dae Hyeon Kim, Taeyoung Yun, Ji Hyeon Park, Bubse Na, Kwon Joong Na, Hyun Joo Lee, Ji Soo Park, Dong In Suh, Jimyung Park, In Kyu Park, Chang Hyun Kang, Young Tae KimABSTRACT
Objective
Long‐term multidimensional evaluations of pediatric lung transplantation are limited. This study assessed the functional recovery, volumetric adaptation, and growth in pediatric recipients by comparing age and graft type.
Methods
This single‐center, retrospective, descriptive study longitudinally reviewed 16 children (age < 18 years) who underwent bilateral deceased‐donor lung transplantation. Perioperative characteristics, pulmonary function, computed tomography (CT)–derived lung volume, somatic growth, and survival were analyzed. Overall survival (OS) and chronic lung allograft dysfunction (CLAD)–free survival were estimated using the Kaplan–Meier method, and longitudinal physiological and developmental patterns were assessed descriptively.
Results
In the younger group (≤ 10 years, n = 7) and the older group (> 10 years, n = 9), lobar transplantation was performed in 5 (71.4%) and 3 (33.3%) patients, respectively. CLAD was diagnosed in 1 younger recipient (14.3%) and 2 older recipients (22.2%). OS did not differ significantly between age groups (log‐rank p = 0.96), and CLAD‐free survival was comparable (log‐rank p = 0.73). CT volumetry demonstrated progressive postoperative lung expansion with similar temporal trajectories across age groups and between lobar and whole‐lung grafts. Growth patterns demonstrated meaningful postoperative improvement, with many children who exhibited faltering pretransplant growth demonstrating catch‐up toward individualized percentile curves.
Conclusions
Pediatric lung transplantation results in favorable long‐term recovery, including functional improvement, durable volumetric adaptation, and partial restoration of growth dynamics. Comparable outcomes between lobar and whole‐lung grafts support the use of size‐reduced grafts in cases of donor–recipient mismatch.