Pediatric Heart-Lung Transplants - Underutilized?

摘要

Combined adult heart-lung transplants have d e c l i n e d s t e a d i l y s i n c e a h i g h o f approximately 200 cases per year in the early 1990s to 50 or so cases per year more recently. We’ve seen the same trend in the pediatric realm: a steady decline from 50-60 cases per year to 10 or less today. In the last two years, there was only one pediatric heartlung transplant performed: it was for a 15- year-old patient who presented to our institution, St. Louis Children’s Hospital, in the fall of last year. Simultaneously, the number of adult heart (~4,000/year), adult lungs (~4,000/ year), pediatric heart (~100/year) and pediatric lungs (~100/year) transplants have remained steady. Few centers perform pediatric heart-lung transplants and a majority perform no more than 1 or 2 per year. Why these statistics?