Pediatric Lung Transplantation

Pediatric lung transplantation is a viable, yet rarely utilized, option for infants, children, and adolescents with end-stage pulmonary disease. Although changes in the donor allocation priorities for children and the use of the lung allocation score for adolescents have increased the availability of donor organs, there remains an inherent shortage in donor organs compared to the number of wait-listed candidates. Future opportunities to expand the donor pool, such as ex vivo lung perfusion, donation after circulatory death donors, and extended criteria donors, which are utilized in the adult lung transplant population, remain potential options to explore. While early posttransplant mortality has continued to improve over the past three decades, long-term outcomes are limited by chronic lung allograft dysfunction. This chapter is a review of the contemporary indications, donor allocation policies, surgical approaches, and outcomes of pediatric lung transplantation.