Isolated lung transplantation in children

Pathological diagnosis and incidence of pulmonary complications

Pablo A. Bejarano, Louis P. Dehner, Mark R. Wick, Charles B. Huddleston, Thomas L. Spray, L. Santiago Medina, George B. Mallory

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The pathological findings in the allografts of 14 children who underwent lung transplantation (LT) at St. Louis Children's Hospital, St. Louis, MO, in the period between July 1990 and May 1992 were reviewed. The study is based on histological analysis of 63 transbronchial biopsy (TBB) specimens, eight open lung biopsy specimens, and three pneumonectomy specimens. The mean age at transplantation was 10.5 years (range, 1 to 17 years) and the average follow-up period was 5.7 months. Sufficient tissue for an adequate pathological examination was obtained in 58 (92%) TBB specimens. Each specimen consisted of a mean of 6.12 tissue fragments, but only 4.79 fragments contained actual lung parenchyma for suitable examination. Ten patients (71%) had 23 biopsy-proven episodes of acute rejection with a frequency of 1.64 episodes per patient. The first episode was documented at a mean of 19 days after transplantation. Six patients (42.8%) developed bronchiolitis obliterans (BO). The definitive diagnosis of this condition was made either by open lung biopsy (n = 3) or on allograft pneumonectomy (n = 1), and it was infrequently recognized by TBB. Four of the six patients died less than 9 months after the diagnosis of BO was made, indicating the grave consequences of this complication. Two other deaths were attributed to the development of posttransplantation lymphoproliferative disorders.

Original languageEnglish
Pages (from-to)1179-1184
Number of pages6
JournalHuman Pathology
Volume25
Issue number11
DOIs
StatePublished - Jan 1 1994

Fingerprint

Lung Transplantation
Biopsy
Lung
Incidence
Bronchiolitis Obliterans
Pneumonectomy
Allografts
Transplantation
Lymphoproliferative Disorders

Keywords

  • complications
  • lung
  • pediatric
  • rejection
  • transplantation

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Bejarano, P. A., Dehner, L. P., Wick, M. R., Huddleston, C. B., Spray, T. L., Medina, L. S., & Mallory, G. B. (1994). Isolated lung transplantation in children: Pathological diagnosis and incidence of pulmonary complications. Human Pathology, 25(11), 1179-1184. https://doi.org/10.1016/0046-8177(94)90034-5

Isolated lung transplantation in children : Pathological diagnosis and incidence of pulmonary complications. / Bejarano, Pablo A.; Dehner, Louis P.; Wick, Mark R.; Huddleston, Charles B.; Spray, Thomas L.; Medina, L. Santiago; Mallory, George B.

In: Human Pathology, Vol. 25, No. 11, 01.01.1994, p. 1179-1184.

Research output: Contribution to journalArticle

Bejarano, PA, Dehner, LP, Wick, MR, Huddleston, CB, Spray, TL, Medina, LS & Mallory, GB 1994, 'Isolated lung transplantation in children: Pathological diagnosis and incidence of pulmonary complications', Human Pathology, vol. 25, no. 11, pp. 1179-1184. https://doi.org/10.1016/0046-8177(94)90034-5
Bejarano, Pablo A. ; Dehner, Louis P. ; Wick, Mark R. ; Huddleston, Charles B. ; Spray, Thomas L. ; Medina, L. Santiago ; Mallory, George B. / Isolated lung transplantation in children : Pathological diagnosis and incidence of pulmonary complications. In: Human Pathology. 1994 ; Vol. 25, No. 11. pp. 1179-1184.
@article{7f6a882e796a4cb2ab86961cbcae9aec,
title = "Isolated lung transplantation in children: Pathological diagnosis and incidence of pulmonary complications",
abstract = "The pathological findings in the allografts of 14 children who underwent lung transplantation (LT) at St. Louis Children's Hospital, St. Louis, MO, in the period between July 1990 and May 1992 were reviewed. The study is based on histological analysis of 63 transbronchial biopsy (TBB) specimens, eight open lung biopsy specimens, and three pneumonectomy specimens. The mean age at transplantation was 10.5 years (range, 1 to 17 years) and the average follow-up period was 5.7 months. Sufficient tissue for an adequate pathological examination was obtained in 58 (92{\%}) TBB specimens. Each specimen consisted of a mean of 6.12 tissue fragments, but only 4.79 fragments contained actual lung parenchyma for suitable examination. Ten patients (71{\%}) had 23 biopsy-proven episodes of acute rejection with a frequency of 1.64 episodes per patient. The first episode was documented at a mean of 19 days after transplantation. Six patients (42.8{\%}) developed bronchiolitis obliterans (BO). The definitive diagnosis of this condition was made either by open lung biopsy (n = 3) or on allograft pneumonectomy (n = 1), and it was infrequently recognized by TBB. Four of the six patients died less than 9 months after the diagnosis of BO was made, indicating the grave consequences of this complication. Two other deaths were attributed to the development of posttransplantation lymphoproliferative disorders.",
keywords = "complications, lung, pediatric, rejection, transplantation",
author = "Bejarano, {Pablo A.} and Dehner, {Louis P.} and Wick, {Mark R.} and Huddleston, {Charles B.} and Spray, {Thomas L.} and Medina, {L. Santiago} and Mallory, {George B.}",
year = "1994",
month = "1",
day = "1",
doi = "10.1016/0046-8177(94)90034-5",
language = "English",
volume = "25",
pages = "1179--1184",
journal = "Human Pathology",
issn = "0046-8177",
publisher = "W.B. Saunders Ltd",
number = "11",

}

TY - JOUR

T1 - Isolated lung transplantation in children

T2 - Pathological diagnosis and incidence of pulmonary complications

AU - Bejarano, Pablo A.

AU - Dehner, Louis P.

AU - Wick, Mark R.

AU - Huddleston, Charles B.

AU - Spray, Thomas L.

AU - Medina, L. Santiago

AU - Mallory, George B.

PY - 1994/1/1

Y1 - 1994/1/1

N2 - The pathological findings in the allografts of 14 children who underwent lung transplantation (LT) at St. Louis Children's Hospital, St. Louis, MO, in the period between July 1990 and May 1992 were reviewed. The study is based on histological analysis of 63 transbronchial biopsy (TBB) specimens, eight open lung biopsy specimens, and three pneumonectomy specimens. The mean age at transplantation was 10.5 years (range, 1 to 17 years) and the average follow-up period was 5.7 months. Sufficient tissue for an adequate pathological examination was obtained in 58 (92%) TBB specimens. Each specimen consisted of a mean of 6.12 tissue fragments, but only 4.79 fragments contained actual lung parenchyma for suitable examination. Ten patients (71%) had 23 biopsy-proven episodes of acute rejection with a frequency of 1.64 episodes per patient. The first episode was documented at a mean of 19 days after transplantation. Six patients (42.8%) developed bronchiolitis obliterans (BO). The definitive diagnosis of this condition was made either by open lung biopsy (n = 3) or on allograft pneumonectomy (n = 1), and it was infrequently recognized by TBB. Four of the six patients died less than 9 months after the diagnosis of BO was made, indicating the grave consequences of this complication. Two other deaths were attributed to the development of posttransplantation lymphoproliferative disorders.

AB - The pathological findings in the allografts of 14 children who underwent lung transplantation (LT) at St. Louis Children's Hospital, St. Louis, MO, in the period between July 1990 and May 1992 were reviewed. The study is based on histological analysis of 63 transbronchial biopsy (TBB) specimens, eight open lung biopsy specimens, and three pneumonectomy specimens. The mean age at transplantation was 10.5 years (range, 1 to 17 years) and the average follow-up period was 5.7 months. Sufficient tissue for an adequate pathological examination was obtained in 58 (92%) TBB specimens. Each specimen consisted of a mean of 6.12 tissue fragments, but only 4.79 fragments contained actual lung parenchyma for suitable examination. Ten patients (71%) had 23 biopsy-proven episodes of acute rejection with a frequency of 1.64 episodes per patient. The first episode was documented at a mean of 19 days after transplantation. Six patients (42.8%) developed bronchiolitis obliterans (BO). The definitive diagnosis of this condition was made either by open lung biopsy (n = 3) or on allograft pneumonectomy (n = 1), and it was infrequently recognized by TBB. Four of the six patients died less than 9 months after the diagnosis of BO was made, indicating the grave consequences of this complication. Two other deaths were attributed to the development of posttransplantation lymphoproliferative disorders.

KW - complications

KW - lung

KW - pediatric

KW - rejection

KW - transplantation

UR - http://www.scopus.com/inward/record.url?scp=0027938829&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027938829&partnerID=8YFLogxK

U2 - 10.1016/0046-8177(94)90034-5

DO - 10.1016/0046-8177(94)90034-5

M3 - Article

VL - 25

SP - 1179

EP - 1184

JO - Human Pathology

JF - Human Pathology

SN - 0046-8177

IS - 11

ER -