Lung Transplant Program

Since its inception in 1990, Boston Children’s Lung Transplant Program has improved the lives of hundreds of children with end-stage lung disease. Our lung transplant team evaluates infants, children, and adolescents who are potential candidates for a lung transplant, explores all treatment options, and determines the best option for the optimal outcome for your child.

We work closely with Boston Children’s Division of Pulmonary and Respiratory Diseases, which includes programs and services such as the Interstitial Lung Disease Program, the Center for Healthy Infant Lung Development, the Chronic Pulmonary and Ventilator Program, and the Cystic Fibrosis Center — one of the oldest and largest of its kind in the country. We also work with some of the cardiac programs, including the Pulmonary Hypertension Program and the Pulmonary Vein Stenosis team.

Care for our transplant patients is provided by a team of pediatric specialists specially trained to care for children with end-stage lung disease. The conditions leading to transplant can frequently and significantly differ from those leading to transplant in adults. Our team has the pediatric expertise and experience to treat even the most complex pediatric cases, and we use this expertise to avoid or delay transplant when possible. If lung transplantation is the best option, we will work with you and your family to make certain your child is in the best possible health to ensure a successful outcome.

We recognize that lung transplantation is more than just a surgery. Our program places a unique emphasis on the transplant journey, offering support and care long after your child leaves the hospital. As your child transitions from an adolescent to young adult, we will help them manage their own health care and adapt to the challenges of adhering to a medication schedule.

Our program is a multidisciplinary effort between the medical and surgical teams at Boston Children's. Together we provide comprehensive care to children with a variety of diagnoses, including:

• chronic lung disease
• cystic fibrosis (with and without multi-resistant organisms)
• pulmonary vein stenosis
• interstitial lung disease and other end-stage lung diseases

We also care for children in need of lung re-transplantation, as well as those on mechanical support (ventilator and/or ECMO), due to severe respiratory failure. Our lung transplant team collaborates with the adult lung transplant program at Brigham and Women’s Hospital, also in Boston, a partnership that advances research on transplantation and allows clinicians to share best practices.

In some cases, when your child is waiting for a lung transplant, he or she may need a special treatment plan to medically support breathing while waiting for donor lungs to become available. Or your child may need a therapy that helps build up the necessary strength to successfully undergo a transplant operation. Boston Children's clinicians offer an innovative technology that does all that, and allows the patient to remain alert and awake the entire time.

The Quadrox membrane oxygenator is a lung-assist device that adds oxygen to the blood in the same way a healthy pair of lungs would. Traditionally, the Quadrox is used as part of ECMO, a special device therapy that doctors use to support a child who is waiting for a heart transplant.

To better treat those patients who only need lung assistance, and do not require the complete assistance of ECMO, Boston Children's doctors developed a unique method to take the Quadrox device out of the ECMO process and offer it to patients in need. This means patients who use the Quadrox receive all the lung assistance they require without being subjected to the risks associated with ECMO. Patients remain awake, alert, and are able to move and interact with their parents and caregivers while the Quadrox supplies their blood with oxygen.

Our lung transplant research is aimed at preventing both short- and long-term lung transplant injury, the development of transplant tolerance, and novel therapies for long-term acceptance of transplanted lungs. An induction protocol, begun in 2008, has reduced acute cellular rejection first year post-transplant to less than 5 percent, compared to the expected 40 to 50 percent.

Globally, lung transplant research has been slow because there are comparatively few of them performed. Boston Children’s is hoping to help solve that problem by conducting research as a member of the International Pediatric Lung Transplantation Collaboration, an organization founded to give lung transplant researchers as much data to work with as possible.