<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-1249</journal-id>
<journal-title><![CDATA[Archivos de Pediatría del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Pediatr. Urug.]]></abbrev-journal-title>
<issn>1688-1249</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-12492024000201211</article-id>
<article-id pub-id-type="doi">10.31134/ap.95.s1.3</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Características de los niños y adolescentes con enfermedades pulmonares crónicas derivados para evaluación por equipo de trasplante pulmonar de Uruguay en el período 2003 - 2023]]></article-title>
<article-title xml:lang="en"><![CDATA[Characteristics of children and adolescents with chronic lung diseases referred for assessment by the Uruguayan lung transplant team in 2003 - 2023]]></article-title>
<article-title xml:lang="pt"><![CDATA[Características de crianças e adolescentes com doenças pulmonares crônicas referidas para avaliação pela equipe uruguaia de transplante pulmonar no período 2003 - 2023]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Amaro]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Perrone]]></surname>
<given-names><![CDATA[Marcela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinchak]]></surname>
<given-names><![CDATA[Catalina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tommasino]]></surname>
<given-names><![CDATA[Nicolás]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chao]]></surname>
<given-names><![CDATA[Cecilia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villanueva]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marina]]></surname>
<given-names><![CDATA[Katia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mussetti]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Curbelo]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,CHPR Servicio de Neumología Pediátrica ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR Facultad de Medicina Clínica Pediátrica B]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,UDELAR Facultad de Medicina Clínica Pediátrica B]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,UDELAR Facultad de Medicina Cátedra de Neumología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>95</volume>
<numero>nspe1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-12492024000201211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-12492024000201211&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-12492024000201211&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[resumen está disponible en el texto completo]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary:  Introduction:  lung transplantation has been recently consolidated as a therapeutic option for children and adolescents with severe lung disease when other treatments have failed. This procedure provides a good quality of life and additional survival, similar to that of transplantation in adult patients. The general indication for lung transplantation is progressive, potentially fatal respiratory failure due to parenchymal or vascular lung disease. The selection of transplant candidates is complex, requiring specific medical and socio-environmental conditions.  Objectives: to analyze the clinical characteristics of pediatric patients with chronic lung diseases referred for evaluation by the Uruguayan lung transplant team. To analyze the clinical characteristics and survival of Uruguayan pediatric lung transplant patients.  Material and methods: descriptive and retrospective study of all patients under 19 years of age referred to the lung transplant team between 2003 and 2023. The data was obtained from the program&#8217;s database and through medical records&#8217; review.  Results:  30 patients were included (15 male). The mean age of the referred patients was 13.4 ± 3.6 years. Etiologies were 17/30 (56.6%) cystic fibrosis, 4/30 (13.3%) bronchiolitis obliterans post-bone marrow transplant, 4/30 (13.3%) pulmonary hypertension, 3 /30 (10%) post-infectious bronchiolitis obliterans, and 2/30 (6.6%) diffuse interstitial lung disease. 14 patients were placed on the transplant list, of which 9 were transplanted, 1 remains on the waiting list and 4 died while waiting for the transplant. Of the rest of the patients referred for evaluation: 7 patients are still under evaluation. 2 patients were excluded for psychosocial reasons or medical reasons. 2 patients could not be followed-up and other 5 died during the evaluation. The etiologies of the pediatric transplant patients were cystic fibrosis (3/9), post-bone marrow transplant bronchiolitis obliterans (3/9), and pulmonary hypertension (3/9). Of the transplanted patients, 5 died (two in the post-operative period, and three died from sepsis between 1-2 years post-transplant). The remaining patients are in post-transplant follow-up for 1 month, 2, 7 and 9 years. No statistically significant differences in conditional survival were found when comparing adult and pediatric patients.  Conclusions:  results in transplanted patients in terms of characteristics and causes of mortality are comparable with those reported internationally. Post-transplant mortality was somewhat higher than in other studies, but we believe that there is bias due to the low number of patients. Given the results above, we propose that transplantation continues to be a valid therapeutic alternative in our country. The challenges of this treatment include the limited availability of suitable donor organs, the toxicity of immunosuppressive medications necessary to prevent rejection, prevention and treatment of bronchiolitis obliterans, as well as maximizing the growth, development and quality of life of the receivers.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: o transplante pulmonar consolidou-se nos últimos anos como opção terapêutica para crianças e adolescentes com doença pulmonar grave, nas quais outros tratamentos falharam. Esse procedimento proporciona boa qualidade de vida e sobrevida prolongada, semelhante ao transplante realizado em pacientes adultos. A indicação geral para transplante pulmonar é insuficiência respiratória progressiva e potencialmente fatal devido a doença pulmonar parenquimatosa ou vascular. A seleção de candidatos a transplantes é complexa, exigindo condições médicas e socioambientais específicas.  Objetivos:  analisar as características clínicas de pacientes pediátricos com doenças pulmonares crônicas encaminhados para avaliação pela equipe uruguaia de transplante pulmonar. Analisar as características clínicas e a sobrevida de pacientes pediátricos uruguaios transplantados pulmonares.  Material e métodos:  estudo descritivo e retrospectivo de todos os pacientes menores de 19 anos encaminhados à equipe de transplante pulmonar entre 2003 e 2023. Os dados foram obtidos no banco de dados do programa e por meio de revisão de prontuários. Foram incluídos 30 pacientes (15 do sexo masculino). A média de idade dos pacientes encaminhados foi de 13,4 ± 3,6 anos. As etiologias dos pacientes encaminhados foram 17/30 (56,6%) fibrose cística, 4/30 (13,3%) bronquiolite obliterante pós-transplante de medula óssea, 4/30 (13,3%) hipertensão pulmonar, 3/30 (10%) pós -bronquiolite obliterante infecciosa e 2/30 (6,6%) doença pulmonar intersticial difusa. Foram colocados na lista de transplante 14 pacientes, dos quais 9 foram transplantados, 1 permanece em lista de espera e 4 faleceram enquanto aguardavam o transplante. Do restante dos pacientes encaminhados para avaliação: 7 pacientes ainda estão em avaliação, 2 pacientes foram excluídos por motivos psicossociais ou médicos. 2 pacientes foram perdidos no acompanhamento e outros 5 faleceram durante a avaliação. As etiologias dos pacientes transplantados pediátricos foram fibrose cística (3/9), bronquiolite obliterante pós-transplante de medula óssea (3/9) e hipertensão pulmonar (3/9). Dos pacientes transplantados, 5 faleceram (dois no pós-operatório e três por sepse entre 1-2 anos pós-transplante). Os demais pacientes estão em acompanhamento pós-transplante por 1 mês, 2, 7 e 9 anos. Não foram encontradas diferenças estatisticamente significativas na sobrevida condicional quando comparamos pacientes adultos e pediátricos.  Conclusões: os resultados em pacientes transplantados em termos de características e causas de mortalidade são comparáveis aos relatados internacionalmente. A mortalidade pós-transplante foi um pouco maior do que em outros estudos, mas acreditamos que exista viés devido ao baixo número de pacientes. Diante dos resultados acima mencionados, propomos que o transplante continue sendo uma alternativa terapêutica válida em nosso meio. Os desafios deste tratamento incluem a disponibilidade limitada de órgãos de doadores adequados, a toxicidade dos medicamentos imunossupressores necessários para prevenir a rejeição, prevenção e tratamento da bronquiolite obliterante, bem como maximizar o crescimento, desenvolvimento e qualidade de vida dos receptores.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Enfermedad Pulmonar Obstructiva Crónica]]></kwd>
<kwd lng="es"><![CDATA[Trasplante de Pulmón]]></kwd>
<kwd lng="es"><![CDATA[Pediatría]]></kwd>
<kwd lng="en"><![CDATA[Chronic Obstructive Pulmonary Disease]]></kwd>
<kwd lng="en"><![CDATA[Lung Transplant]]></kwd>
<kwd lng="en"><![CDATA[Pediatrics]]></kwd>
<kwd lng="pt"><![CDATA[Doença Pulmonar Obstrutiva Crônica]]></kwd>
<kwd lng="pt"><![CDATA[Transplante Pulmonar]]></kwd>
<kwd lng="pt"><![CDATA[Pediatria]]></kwd>
</kwd-group>
</article-meta>
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