Pediatric Lung Transplant

If your child needs a lung transplant, our multidisciplinary team at the Miami Transplant Institute will provide the best possible care. Our team has been doing lung transplants since 1996 and is considered one of the leading lung transplant centers in the nation. Our pediatric lung transplantation program—one of only a handful in the U.S.—focuses on helping children with congenital lung and lung conditions. Our young patients also appreciate our specially designed pediatric intensive care unit with well-trained and experienced physicians caring for them before, during, and after surgery.

A pediatric lung transplant is a surgery in which one or both of your child’s diseased or injured lungs are replaced with healthy lungs from a deceased donor. Unhealthy or injured lungs can make it difficult for the body to receive the oxygen it needs to live. If your child has severe end-stage lung disease that no longer responds to treatment, a lung transplant might be an option to offer a longer and healthier life. Most children who need a lung transplant will have both lungs replaced.

A lung transplant is an option for children with chronic lung diseases when other treatments no longer work or their lung function becomes life-threatening. For children, the most common condition is cystic fibrosis, which is a genetic chronic disease that can affect many parts of a child’s body, including breathing, digestion, and growth. Other conditions that may require a pediatric lung transplant include:

Pediatric lung transplants are not very common because of the limited amount of donor organs available. In 2021, bout 2,500 lung transplants were performed in the United States. As more lungs are donated, the number of lungs that can be transplanted in children will increase as well.

There are three main types of pediatric lung transplants:

In order to be considered for a pediatric lung transplant, your child must be evaluated thoroughly by the lung transplant team. The evaluation usually takes three to four days to complete and is most often done in an outpatient setting. The purpose of this evaluation is to perform a comprehensive assessment of your child’s health, provide education about the transplant process and answer any questions you may have, along with discussing alternative treatment options if necessary.

The evaluation also includes a series of tests and physical examinations to see how severe your child’s lung disease is and to determine if they have any health concerns that could affect recovery. These types of tests may include:

Upon completion of the evaluation, the pediatric lung transplant team will meet to decide whether your child is a suitable candidate for lung transplantation.

If your child is a good candidate for a pediatric lung transplant, they will be placed on the United Network for Organ Sharing (UNOS) lung transplant waiting list. UNOS maintains the national database and matches the donors to recipients using a Lung Allocation Score that is based on blood type, height, chest size, length of time on the waitlist, and severity of illness. The wait can be from a few days or months to more than a year. When a lung is matched, you will be contacted to immediately visit the hospital.

Before surgery, the transplant team will examine your child and conduct blood work and tests to confirm the match of the organ. Then your child will be transferred to the operating room where they will receive general anesthesia through an IV line to prevent pain and put your child to sleep. A ventilator to help with breathing will also be used. Their heart rate, blood pressure, and breathing will be monitored during the entire procedure.

Most children who need a lung transplant will have both lungs replaced. During a double-lung transplant, the surgeon will make an incision horizontally across the chest below the breasts. If necessary, your child may be put on a cardiopulmonary machine to send blood and oxygen to their body.  The surgeon will then remove both of the diseased or damaged lungs, one at a time, and replace them with the healthy donor lungs. The new lung’s blood vessels and airways will be attached to the body, then the incision will be closed with staples or stitches.  There will be several chest tubes attached to help drain fluid and air from around the new lungs. Typically, a double lung transplant surgery lasts from 6 to 12 hours.

After the lung transplant surgery, your child will be taken to the intensive care unit (ICU) and be monitored closely. They may be in the hospital for 7 to 14 days or longer. Once your child has stabilized after their lung transplant surgery, the transplant nurse coordinators will educate you and your child about transplant medications. They will also work with you throughout your child’s hospitalization to teach you any special skills you may need to take care of your child at home. Some of these essential skills include:

Prior to discharge from the hospital, you will receive detailed information regarding your child’s medication regimen including doses, schedule, indications, and side effects. Children will need to take immunosuppression medications for the rest of their lives after transplant surgery. These medications are necessary to prevent complications such as rejection, which occurs when the body perceives the new lungs as foreign and attacks them.

For the first few months after pediatric lung transplant surgery, your child will need to be seen by the transplant team two times a week. Your child will also be required to participate in physical therapy at least three times a week. This therapy is essential in helping your child recover from surgery and resume activities of daily living. As progress is made, your child will then come to the clinic once a month. After a year passes, your child will be able to visit less often, usually once every three months. This schedule will continue until your child is old enough to transition to an adult transplant center.

Living with a lung transplant is a life-long journey. Your child will need to take medications and have routine follow-up appointments to monitor their health for the rest of their life. After a lung transplant, most children will be able to return to school within three to six months. Your child’s overall quality of life should be improved and they will be able to do many of the activities they enjoy.

As an academic transplant center, we conduct clinical trials and can apply the latest research findings to clinical care. For example, we are able to put donor lungs in respiratory function equipment and test their capability before implanting them into a patient.

These are some of the ways our lung transplant program is saving lives while leading the way into the future.