Volume 188 - Issue 7
Successful lung transplantation for adolescents at a hospital for adults
Authors: Judith M Morton and Allan R Glanville
Med J Aust 2008; 188 (7): 430-431. || doi: 10.5694/j.1326-5377.2008.tb01702.x
Published online: 7 April 2008
Published online: 7 April 2008
In reply: We were interested to read about Robotin’s insights gained from her experience at St Louis Children’s Hospital, which has one of the largest and most successful paediatric lung transplantation units in the world. We agree that development of local expertise in paediatric lung transplantation would be a cost-efficient means of offering optimum care to young Australians. Because the experience in lung transplants at St Vincent’s Hospital, Sydney, has grown, we would like to provide this service for younger recipients, but our centre lacks specific expertise and facilities for ongoing paediatric care.
A dedicated paediatric ward with experienced nursing staff in a family-friendly environment is essential to meet world’s best practice in this area. There are many complications of the underlying conditions that might benefit from paediatric specialty expertise.
Our experience emphasises that a close working relationship with the patient and his or her family is crucial, and that distance from the location of care delivery and ease of access to the primary treating team are important factors. Given the tyranny of distance, a single Australian centre would be inefficient. However, analysis of outcomes in adult centres shows superior results with increasing transplantation volume, so the concept of small stand-alone centres is not supported by evidence.2
Logistics dictate that linking paediatric services to existing adult services in Australia should improve long-term outcomes. Our data show that performing adolescent lung transplantation in a centre with proven expertise in adult procedures produces excellent results.
We advocate provision of adequate funding and resources in all Australian transplantation centres to achieve optimum service delivery in paediatric lung transplantation.
References
- Morton JM, Malouf MA, Plit ML, et al. Successful lung transplantation for adolescents at a hospital for adults. Med J Aust 2007; 187: 278-282.
- Trulock EP, Edwards LB, Taylor DO, et al; International Society for Heart and Lung Transplantation. Registry of the International Society for Heart and Lung Transplantation: twenty-third official adult lung and heart-lung transplantation report — 2006. J Heart Lung Transplant 2006; 25: 880-892. 0_i1091825