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Bilateral lung transplantation (BLTx) in a 9-year-old girl with bronchopulmonary dysplasia with pulmonary hypertension
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  • Chiharu Ota,
  • Ryoko Saito,
  • Junya Tominaga,
  • Shinya Iwasawa,
  • Hirama Takashi,
  • Yasushi Matsuda,
  • Katsunori Ono,
  • Takehiko Onoki,
  • Masato Kimura,
  • Yoshinori Kawabata,
  • Yoshinori Okada
Chiharu Ota
Tohoku University Graduate School of Medicine
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Ryoko Saito
Tohoku University Graduate School of Medicine
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Junya Tominaga
Tohoku University Hospital
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Shinya Iwasawa
Tohoku University Hospital
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Hirama Takashi
Tohoku University Hospital
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Yasushi Matsuda
Tohoku University Hospital
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Katsunori Ono
Tohoku University Hospital
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Takehiko Onoki
Tohoku University Hospital
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Masato Kimura
Miyagi Children's Hospital
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Yoshinori Kawabata
Saitama Cardiovascular and Respiratory Center
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Yoshinori Okada
Tohoku University Hospital
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Abstract

Background Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease that occurs in premature infants and the prognosis is variable depending on the comorbidities including fibrosis, emphysema, or pulmonary hypertension (PH). We present a case of a 9-year-old girl who developed PH associated with severe BPD (BPD-PH) and underwent bilateral lung transplantation (BLTx). Case description A 9-year-old girl admitted to our department to undergo BLTx. She was born at 23 weeks and 4 days gestation with a weight of 507 grams. She received ventilation for the first 2 months and required further respiratory care due to repetitive, severe respiratory infections. She was diagnosed with BPD-PH at 6 months of age and oral administration of pulmonary vasodilators were initiated. She was registered as a lung transplant candidate at 4 years of age after the life-threatening exacerbation. Chest computed tomography (CT) revealed severe lung conditions with ground-glass opacities and emphysematous low-density areas in the upper and lower lobes. BLTx from a brain-dead male donor was performed. The pathological findings of her resected lung revealed saccular, hypoplastic lung with alveolar repair/regeneration and medial hypertrophy and muscularization of peripheral arteries. The postoperative course was mostly uneventful. She was free from oxygen administration and showed no signs of PH after 6 months of the surgery. Conclusion This is the first case report of BLTx in a pediatric, irreversible BPD-PH patient with detailed pathohistological findings and clinical examination. Lung transplantation is one of the treatment options for severe BPD-PH.

Peer review status:IN REVISION

17 Mar 2021Submitted to Pediatric Pulmonology
17 Mar 2021Assigned to Editor
17 Mar 2021Submission Checks Completed
18 Mar 2021Reviewer(s) Assigned
20 Apr 2021Review(s) Completed, Editorial Evaluation Pending
22 Apr 2021Editorial Decision: Revise Major