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    儿童肺移植的最新进展和挑战

    Latest advances and challenges in pediatric lung transplantation

    • 摘要: 肺移植是儿童晚期肺部疾病和肺血管疾病的有效治疗手段,可以延长患儿的生存时间,提高生活质量。当前全球儿童肺移植已开展超过2 500例,由于儿童供受体匹配差、手术难度大和术后并发症多,儿童肺移植的开展范围较成人肺移植小。近年来,儿童受体候选标准和供肺分配制度不断更新,移植术式尤其是减容肺叶移植术开展日渐增多。随着儿童肺移植围术期管理经验不断积累,肺移植预后显著改善。本文对儿童肺移植的适应证和禁忌证、供受体匹配机制、移植技术、术后并发症处理的最新进展进行综述,为临床诊治提供借鉴。

       

      Abstract: Lung transplantation is an effective treatment for end-stage lung disease and pulmonary vascular disease in children. It can prolong the survival time of children and improve their quality of life. Currently, more than 2 500 pediatric lung transplantations have been performed worldwide. Due to poor donor recipient match, difficult surgery and numerous postoperative complications, the scope of pediatric lung transplant is smaller than that of adult lung transplant. In recent years, the candidate criteria for pediatric recipient and the allocation system for donor have been continuously updated, and transplantation techniques, especially reduced volume lobar transplantation have been increasingly performed. With the accumulation of experience in perioperative management of pediatric lung transplantation, the prognosis of lung transplantation has also been significantly improved. This article reviewed the latest advance in indication and contraindication for pediatric lung transplantation, donor recipient match mechanism, transplantation techniques, and management of postoperative complication, to provide guidelines for clinical diagnosis and treatment.

       

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