Pediatric Lung Transplantation Shifts Focus

6:08 PM ETDeveloping

Health Desk

In Short: New guidelines address changing trends in lung transplants for children, with cystic fibrosis no longer the dominant reason.

At the European Respiratory Society Congress in Barcelona, Christian Benden, MD, director of the pediatric lung transplant program at Boston Children’s Hospital, highlighted a significant shift in pediatric lung transplantation due to advancements in cystic fibrosis (CF) treatment.

According to Benden, the introduction of CFTR modulators has transformed the landscape, leading to a decline in lung transplants for CF. The International Society for Heart and Lung Transplantation (ISHLT) registry data supports this trend, showing a historic decrease in CF-related transplants.

The decline is not solely attributed to the COVID-19 pandemic but rather reflects an underlying trend linked to the increasing efficacy of CFTR modulators. These medications have improved the quality of life and extended the lifespan of many CF patients, reducing the need for lung transplants.

The ISHLT registry also reveals a rise in transplants for childhood interstitial lung disease, particularly in North America. In 2021, these cases accounted for 27% of pediatric lung transplants in North America, up from a peak of 51.6% in 2013 in the US and 60% in Europe.

The new ISHLT consensus guidelines now specifically address the management and selection of pediatric candidates for lung transplantation, reflecting the evolving nature of the field. Conditions such as childhood interstitial lung disease, pulmonary arterial hypertension, and selected forms of obliterative bronchiolitis are now accounting for a larger share of pediatric lung transplant cases.

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