BACKGROUND: Long-term success in pediatric lung transplantation is limited by infection and @entity4154 ( @entity4154 ). The bilateral sequential lung transplantation (BSLT) technique may result in @entity63 leading to @entity850 , dehiscence, or loss of small airways. En bloc lung transplant (EBLT) with bronchial artery revascularization (BAR) minimizes @entity63 , thus promoting superior airway healing. BAR also allows for safe tracheal @entity254 , circumventing the need for bilateral bronchial anastomoses in small @entity1 . METHODS: This was a retrospective review of bilateral transplantations from 2005 to 2014. Both techniques were used in parallel. Redo and multiorgan transplants were excluded. RESULTS: There were 119 recipients comprising 88 BSLTs and 31 EBLTs. Follow-up time was 3 years (interquartile range, 1-5 years). Donor @entity63 and cardiopulmonary bypass times were not different between techniques (p = 0.48 and p = 0.18, respectively). Degree of @entity813 and cellular rejection scores were not different (p = 0.83 and p = 0.93, respectively). There were 3 hospital deaths after BSLT and 2 after EBLT (p = 0.60). Overall survival was 61% for the BSLT group and 77% for the EBLT group (p = 0.54). Freedom from @entity4154 was 71% in the BSLT group and 94% in the EBLT group (p = 0.08). On routine bronchoscopy, 57% BSLT and 16% EBLT @entity1 had 1 or more airway @entity63 findings (p < 0.0001). Multivariate analysis showed BSLT was associated with higher @entity63 (relative risk, 2.86; 95 confidence interval, 1.3-6.5; p = 0.01) and non-airway complications (relative risk, 4.62; 95% confidence interval, 1.1-20.2; p = 0.04) but not airway reinterventions (p = 0.07). Airway dehiscence occurred in 3 BSLT @entity1 . CONCLUSIONS: Pediatric EBLT with BAR can be safely performed without increasing operative or graft @entity63 times. Airway @entity63 and non-airway complications were significantly reduced when BAR was combined with tracheal @entity254 , potentially diminishing morbidity caused by @entity532 .

Bronchial Artery Revascularization and En Bloc Lung Transplant in XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic injury', 'airway ischemia', 'ischemia', 'ischemic'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity532 :: ('MESH:D003925', 'Disease') :: ['anastomotic healing complications'] @entity813 :: ('MESH:D055031', 'Disease') :: ['graft dysfunction'] @entity4154 :: ('MESH:D001989', 'Disease') :: ['BOS', 'bronchiolitis obliterans syndrome'] @entity850 :: ('MESH:D003251', 'Disease') :: ['bronchial stenosis']
@entity1 :: (9606,Species) :: ['Children']
