{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:08:24Z","timestamp":1784740104632,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T00:00:00Z","timestamp":1704153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Premature infants surviving beyond a postmenstrual age (PMA) of 36 weeks with severe or grade 3 bronchopulmonary dysplasia (sBPD) have significant predischarge mortality. The in\u2010hospital mortality for BPD supported by invasive mechanical ventilation beyond 36 weeks PMA is not well described. The role of lung transplantation in treating severe BPD is uncertain. We studied our experience over 20 years to better define the predischarge mortality of infants with progressive grade 3 BPD and whether lung transplant is a feasible intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from a retrospective review of medical records from Children's Minnesota over a 20\u2010year period (1997\u20132016). Inclusion criteria included prematurity &lt;32 weeks PMA, BPD, tracheostomy for chronic respiratory failure, and survival beyond 36 weeks PMA. Collected data included perinatal demographics, in\u2010hospital medications and interventions, level of respiratory support, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 2374 infants were identified who survived beyond 36 weeks PMA with a diagnosis of &lt;32 weeks gestation prematurity and BPD. Of these, 143\/2374 (6.0%) survived beyond 36 weeks PMA and required invasive mechanical ventilation with subsequent tracheostomy for management. Among these patients, discharge to home with tracheostomy occurred in 127\/143 (88.8%), and predischarge death or lung transplantation occurred in 16\/143 (11.2%). Deteriorating cardiopulmonary status was associated with pulmonary hypertension, prolonged hypoxemic episodes and the need for deep sedation or neuromuscular relaxation. Three of four patients referred for lung transplantation had &gt;5\u2010year survival, chronic allograft rejection, and mild to moderate developmental delays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Chronic respiratory failure requiring invasive mechanical ventilation for grade 3 BPD is associated with significant morbidity and mortality. For selected patients and their families, timely referral for lung transplantation is a viable option for end\u2010stage grade 3 BPD. As in other infants receiving solid organ transplants, long\u2010term issues with co\u2010morbidities and special needs persist into childhood.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26837","type":"journal-article","created":{"date-parts":[[2024,1,2]],"date-time":"2024-01-02T17:06:48Z","timestamp":1704215208000},"page":"867-873","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predischarge death or lung transplantation in tracheostomy and ventilator dependent grade 3 bronchopulmonary dysplasia"],"prefix":"10.1002","volume":"59","author":[{"given":"Roy","family":"Maynard","sequence":"first","affiliation":[{"name":"Children's Minnesota Minneapolis Minnesota USA"},{"name":"Pediatric Home Service Roseville Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Unit, Department of Surgery Johns Hopkins University Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"O'Grady","sequence":"additional","affiliation":[{"name":"Children's Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Moore","sequence":"additional","affiliation":[{"name":"Children's Minnesota Minneapolis Minnesota USA"},{"name":"Children's Respiratory and Critical Care Specialists Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kurachek","sequence":"additional","affiliation":[{"name":"Children's Minnesota Minneapolis Minnesota USA"},{"name":"Children's Respiratory and Critical Care Specialists Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George B.","family":"Mallory","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Pediatric Pulmonology Texas Children's Hospital and Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5342-7564","authenticated-orcid":false,"given":"William","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Children's Minnesota Minneapolis Minnesota USA"},{"name":"Children's Respiratory and Critical Care Specialists Minneapolis Minnesota 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