Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations

Background: Infant lung transplantation (LuTx) has been rarely performed in Europe and poses unique challenges. Methods: We reviewed referrals for LuTx to our center for patients below 1 year of age from January 1, 2018 to December 31, 2022. Clinical data and outcomes of transplanted infants and dat...

Full description

Saved in:
Bibliographic Details
Main Authors: Anna Katharina Zürn, MD, Nicolaus Schwerk, MD, Carsten Müller, MD, Gregor Warnecke, MD, Jawad Salman, MD, Michael Sasse, MD, Harald Köditz, MD, Thomas Jack, MD, Bettina Bohnhorst, MD, Gesine Hansen, MD, Oliver Keil, MD, Katja Nickel, MD, Dmitry Bobylev, MD, Fabio Ius, MD, Julia Carlens, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:JHLT Open
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2950133425000461
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849389569130102784
author Anna Katharina Zürn, MD
Nicolaus Schwerk, MD
Carsten Müller, MD
Gregor Warnecke, MD
Jawad Salman, MD
Michael Sasse, MD
Harald Köditz, MD
Thomas Jack, MD
Bettina Bohnhorst, MD
Gesine Hansen, MD
Oliver Keil, MD
Katja Nickel, MD
Dmitry Bobylev, MD
Fabio Ius, MD
Julia Carlens, MD
author_facet Anna Katharina Zürn, MD
Nicolaus Schwerk, MD
Carsten Müller, MD
Gregor Warnecke, MD
Jawad Salman, MD
Michael Sasse, MD
Harald Köditz, MD
Thomas Jack, MD
Bettina Bohnhorst, MD
Gesine Hansen, MD
Oliver Keil, MD
Katja Nickel, MD
Dmitry Bobylev, MD
Fabio Ius, MD
Julia Carlens, MD
author_sort Anna Katharina Zürn, MD
collection DOAJ
description Background: Infant lung transplantation (LuTx) has been rarely performed in Europe and poses unique challenges. Methods: We reviewed referrals for LuTx to our center for patients below 1 year of age from January 1, 2018 to December 31, 2022. Clinical data and outcomes of transplanted infants and data on patients who were declined for evaluation, not listed after evaluation, or died before LuTx were collected. The number of donor lungs from organ donors younger than 1 year of age offered to our center and their utilization were analyzed for the same time period. Results: A total of 18 referrals were analyzed. Ten referrals were declined; 2 had contraindications to transplant and 2 infants died after full evaluation. A total of 4 infants (median age 185 days, range 85-225; mean weight 6063 g, standard deviation [SD] ±438 g) underwent bilateral LuTx after a mean waiting time of 52, SD ±43 days. Underlying diseases included surfactant protein deficiencies (n = 3) and lung hypoplasia with pulmonary hypertension due to congenital diaphragmatic hernia (n = 1). Patients required oxygen supplementation (n = 1), noninvasive (n = 1), or invasive (n = 2) ventilation pre-LuTx. ABO blood group incompatible LuTx was performed in 2 patients. After a mean follow-up of 37, SD ±20 months, all patients are alive. Of 13 infant donor lungs offered to our center, 10 (76.9%) were declined due to the lack of a suitable recipient. Two of 3 infant donor lungs were transplanted to infants, 1 was transplanted to a 23-month-old recipient. The other 2 infants received lungs from donors aged over 12 months. Conclusions: Our longitudinal analysis highlights the high pre-LuTx morbidity of infants with respiratory failure and challenges associated with timely evaluation and listing. Nevertheless, infant LuTx shows promising results in selected candidates, including ABO blood group incompatible transplantations.
format Article
id doaj-art-4c8ead52d1704c5aaf3416a4bf5afae1
institution Kabale University
issn 2950-1334
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series JHLT Open
spelling doaj-art-4c8ead52d1704c5aaf3416a4bf5afae12025-08-20T03:41:56ZengElsevierJHLT Open2950-13342025-08-01910025110.1016/j.jhlto.2025.100251Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantationsAnna Katharina Zürn, MD0Nicolaus Schwerk, MD1Carsten Müller, MD2Gregor Warnecke, MD3Jawad Salman, MD4Michael Sasse, MD5Harald Köditz, MD6Thomas Jack, MD7Bettina Bohnhorst, MD8Gesine Hansen, MD9Oliver Keil, MD10Katja Nickel, MD11Dmitry Bobylev, MD12Fabio Ius, MD13Julia Carlens, MD14Department of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, Germany; Corresponding author: Anna Katharina Zürn, MD, Department of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, Germany.Department of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, GermanyDepartment of Cardiac Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, GermanyDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Cardiology and Critical Care Medicine, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Cardiology and Critical Care Medicine, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Cardiology and Critical Care Medicine, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, GermanyClinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, GermanyClinic of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Hannover, GermanyDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, GermanyDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, Hannover, GermanyDepartment of Pediatric Pneumology Allergology and Neonatology, Hannover Medical School, Hannover, GermanyBackground: Infant lung transplantation (LuTx) has been rarely performed in Europe and poses unique challenges. Methods: We reviewed referrals for LuTx to our center for patients below 1 year of age from January 1, 2018 to December 31, 2022. Clinical data and outcomes of transplanted infants and data on patients who were declined for evaluation, not listed after evaluation, or died before LuTx were collected. The number of donor lungs from organ donors younger than 1 year of age offered to our center and their utilization were analyzed for the same time period. Results: A total of 18 referrals were analyzed. Ten referrals were declined; 2 had contraindications to transplant and 2 infants died after full evaluation. A total of 4 infants (median age 185 days, range 85-225; mean weight 6063 g, standard deviation [SD] ±438 g) underwent bilateral LuTx after a mean waiting time of 52, SD ±43 days. Underlying diseases included surfactant protein deficiencies (n = 3) and lung hypoplasia with pulmonary hypertension due to congenital diaphragmatic hernia (n = 1). Patients required oxygen supplementation (n = 1), noninvasive (n = 1), or invasive (n = 2) ventilation pre-LuTx. ABO blood group incompatible LuTx was performed in 2 patients. After a mean follow-up of 37, SD ±20 months, all patients are alive. Of 13 infant donor lungs offered to our center, 10 (76.9%) were declined due to the lack of a suitable recipient. Two of 3 infant donor lungs were transplanted to infants, 1 was transplanted to a 23-month-old recipient. The other 2 infants received lungs from donors aged over 12 months. Conclusions: Our longitudinal analysis highlights the high pre-LuTx morbidity of infants with respiratory failure and challenges associated with timely evaluation and listing. Nevertheless, infant LuTx shows promising results in selected candidates, including ABO blood group incompatible transplantations.http://www.sciencedirect.com/science/article/pii/S2950133425000461infantlung transplantationABO incompatible transplantationdonor lungsGermany
spellingShingle Anna Katharina Zürn, MD
Nicolaus Schwerk, MD
Carsten Müller, MD
Gregor Warnecke, MD
Jawad Salman, MD
Michael Sasse, MD
Harald Köditz, MD
Thomas Jack, MD
Bettina Bohnhorst, MD
Gesine Hansen, MD
Oliver Keil, MD
Katja Nickel, MD
Dmitry Bobylev, MD
Fabio Ius, MD
Julia Carlens, MD
Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
JHLT Open
infant
lung transplantation
ABO incompatible transplantation
donor lungs
Germany
title Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
title_full Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
title_fullStr Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
title_full_unstemmed Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
title_short Infant lung transplantation: First German experience including two cases of ABO blood group incompatible transplantations
title_sort infant lung transplantation first german experience including two cases of abo blood group incompatible transplantations
topic infant
lung transplantation
ABO incompatible transplantation
donor lungs
Germany
url http://www.sciencedirect.com/science/article/pii/S2950133425000461
work_keys_str_mv AT annakatharinazurnmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT nicolausschwerkmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT carstenmullermd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT gregorwarneckemd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT jawadsalmanmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT michaelsassemd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT haraldkoditzmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT thomasjackmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT bettinabohnhorstmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT gesinehansenmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT oliverkeilmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT katjanickelmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT dmitrybobylevmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT fabioiusmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations
AT juliacarlensmd infantlungtransplantationfirstgermanexperienceincludingtwocasesofabobloodgroupincompatibletransplantations