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Peritransplant Management

  • George B. Mallory
  • Maria Carolina Gazzaneo
  • Ernestina Melicoff-Portillo
Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

The management of the pediatric organ donor is a clinical challenge. Infants and children listed for lung transplantation continue to die at a high rate after transplant listing without receiving suitable organs. Despite the low overall numbers of pediatric lung transplant candidates, wait list mortality remains a problem. The lung donor organ shortage mandates early and accurate listing criteria for recipients of different ages. Donor management is particularly significant for lungs, which represent the donor organ most susceptible to disqualification on the basis of clinical or radiographic assessment. The increasing use of informed donor management protocols has been successful in increasing the number of transplantable organs in adults and should be applied to infants and children. Other means of increasing the donor pool include expanding geographic boundaries for the distribution of pediatric lungs, the use of more extended criteria for acceptability of donor lungs, the application of ex vivo lung perfusion systems to condition suboptimal pediatric lungs, the performance of lobar transplantation from larger donors, the use of lungs from donors after circulatory determination of death, the transplantation of blood type-incompatible lungs in selected infants and young children, and the eventual availability of three-dimensional printing of organ scaffolds.

Keywords

Size matching Donor management protocol Ventilator-associated pneumonia Ex vivo lung perfusion Lobar transplantation Donation after circulatory determination of death Blood type-incompatible transplant Living donor lobar transplantation Organ printing 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • George B. Mallory
    • 1
  • Maria Carolina Gazzaneo
    • 1
  • Ernestina Melicoff-Portillo
    • 1
  1. 1.Department of Pediatrics, Section of PulmonologyTexas Children’s Hospital and the Baylor College of MedicineHoustonUSA

Section editors and affiliations

  • S. B. Goldfarb
    • 1
  1. 1.The Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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