The Nordic Experience of Pediatric Heart‐Lung Transplantation

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Main Authors: Oscar van der Have, Michal Odermarsky, Thomas Möller, Klaus Juul, Timo Jahnukainen, Ilse Duus Weinreich, Taisto Sarkola, Anu K. Kaskinen, Karin Tran‐Lundmark, Håkan Wåhlander
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Published: Wiley 2026
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author Oscar van der Have
Michal Odermarsky
Thomas Möller
Klaus Juul
Timo Jahnukainen
Ilse Duus Weinreich
Taisto Sarkola
Anu K. Kaskinen
Karin Tran‐Lundmark
Håkan Wåhlander
author_facet Oscar van der Have
Michal Odermarsky
Thomas Möller
Klaus Juul
Timo Jahnukainen
Ilse Duus Weinreich
Taisto Sarkola
Anu K. Kaskinen
Karin Tran‐Lundmark
Håkan Wåhlander
Oscar van der Have
Michal Odermarsky
Thomas Möller
Klaus Juul
Timo Jahnukainen
Ilse Duus Weinreich
Taisto Sarkola
Anu K. Kaskinen
Karin Tran‐Lundmark
Håkan Wåhlander
collection Wiley Open Access
contents The Nordic Experience of Pediatric Heart‐Lung Transplantation Oscar van der Have Michal Odermarsky Thomas Möller Klaus Juul Timo Jahnukainen Ilse Duus Weinreich Taisto Sarkola Anu K. Kaskinen Karin Tran‐Lundmark Håkan Wåhlander Clinical Transplantation ABSTRACT Background Pediatric heart‐lung transplantation (pHLTx) remains the only treatment option for children with significant and fixed elevation of pulmonary vascular resistance (PVR) in the setting of uncorrectable end‐stage heart disease. We aimed to determine the characteristics, waiting list course and long‐term outcomes for children listed for pHLTx within the Scandiatransplant region. Methods This was a multinational, retrospective observational cohort study comprising all children <18 years of age residing in Denmark, Estonia, Finland, Iceland, Norway and Sweden that were listed for pHLTx from January first 1987 until December 31 st 2024. Data were extracted from the Scandiatransplant registry database. Results Thirty‐two children were listed for pHLTx during the study period. Seventeen (53.1%) reached transplantation with a peak in listing and transplantation during the 1990ies. Median age at listing was 12.1 years (range 1.5–17.6, IQR 7.6–15.8). No infants <1 year were listed for pHLTx and there was no re‐listing for re‐transplantation during the study period. Congenital heart disease (CHD) with Eisenmenger´s syndrome was the cause of listing and transplantation in most cases (60.7% and 58.8%, respectively). Median waiting list duration was 268 days (range 3–3409, IQR 109–822). All‐cause posttransplant 30‐day mortality was 17.6% ( n = 3). Kaplan–Meier estimated survival was 76.5% at 1 year, 35.3% at 5 years and 23.5% at 10 years posttransplant. Conclusion Low numbers of pHLTx has been performed in Scandinavia. Long‐term outcomes were unfavorable, but comparable to other larger international and North American registries. The declining number of performed pHLTx may result from a combination of poor prognosis, declining incidence of Eisenmenger´s syndrome, improved surgical techniques for cardiac repair combined with lung transplantation, and increasing use of lung transplantation for isolated pulmonary vascular disease. 10.1111/ctr.70570 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/ctr.70570
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle The Nordic Experience of Pediatric Heart‐Lung Transplantation
Oscar van der Have
Michal Odermarsky
Thomas Möller
Klaus Juul
Timo Jahnukainen
Ilse Duus Weinreich
Taisto Sarkola
Anu K. Kaskinen
Karin Tran‐Lundmark
Håkan Wåhlander
Clinical Transplantation
The Nordic Experience of Pediatric Heart‐Lung Transplantation Oscar van der Have Michal Odermarsky Thomas Möller Klaus Juul Timo Jahnukainen Ilse Duus Weinreich Taisto Sarkola Anu K. Kaskinen Karin Tran‐Lundmark Håkan Wåhlander Clinical Transplantation ABSTRACT Background Pediatric heart‐lung transplantation (pHLTx) remains the only treatment option for children with significant and fixed elevation of pulmonary vascular resistance (PVR) in the setting of uncorrectable end‐stage heart disease. We aimed to determine the characteristics, waiting list course and long‐term outcomes for children listed for pHLTx within the Scandiatransplant region. Methods This was a multinational, retrospective observational cohort study comprising all children <18 years of age residing in Denmark, Estonia, Finland, Iceland, Norway and Sweden that were listed for pHLTx from January first 1987 until December 31 st 2024. Data were extracted from the Scandiatransplant registry database. Results Thirty‐two children were listed for pHLTx during the study period. Seventeen (53.1%) reached transplantation with a peak in listing and transplantation during the 1990ies. Median age at listing was 12.1 years (range 1.5–17.6, IQR 7.6–15.8). No infants <1 year were listed for pHLTx and there was no re‐listing for re‐transplantation during the study period. Congenital heart disease (CHD) with Eisenmenger´s syndrome was the cause of listing and transplantation in most cases (60.7% and 58.8%, respectively). Median waiting list duration was 268 days (range 3–3409, IQR 109–822). All‐cause posttransplant 30‐day mortality was 17.6% ( n = 3). Kaplan–Meier estimated survival was 76.5% at 1 year, 35.3% at 5 years and 23.5% at 10 years posttransplant. Conclusion Low numbers of pHLTx has been performed in Scandinavia. Long‐term outcomes were unfavorable, but comparable to other larger international and North American registries. The declining number of performed pHLTx may result from a combination of poor prognosis, declining incidence of Eisenmenger´s syndrome, improved surgical techniques for cardiac repair combined with lung transplantation, and increasing use of lung transplantation for isolated pulmonary vascular disease. 10.1111/ctr.70570 http://creativecommons.org/licenses/by/4.0/
title The Nordic Experience of Pediatric Heart‐Lung Transplantation
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.70570