{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T21:58:53Z","timestamp":1778277533003,"version":"3.51.4"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"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 Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Lung transplantation is the primary surgical therapy for end\u2010stage lung disease in children. Bilateral sequential lung transplantation (BSLT) is the most widely used technique across the United States. En\u2010bloc lung transplantation (EBLT) was put forward as an alternative to avoid the complications associated with bronchial anastomoses in smaller children. There are no multi\u2010institutional reports comparing the outcomes of these two techniques.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The United Network for Organ Sharing dataset was queried for patients <=\u200918\u2009years who underwent bilateral lung transplantation from 2002 to 2021. Patients were divided into two groups based on surgical technique: EBLT and BSLT. Demographic and clinical characteristics were compared, along with follow\u2010up survival data. The primary outcome of interest was freedom from death or re\u2010transplantation. Subgroup analysis was performed for patients aged <=5\u2009years.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 919 children received lung transplants during the study period. The EBLT technique was utilized in 80 (8.7%) transplants. EBLT patients were younger (9.5 vs. 15\u2009years,\n p<\/jats:italic>\n \u2009=\u20090.0001) and more likely to be on mechanical ventilation (33.8 vs. 17.3%,\n p<\/jats:italic>\n \u2009=\u20090.0003). EBLT had a lower proportion of cystic fibrosis (37.5 vs. 55.5%,\n p<\/jats:italic>\n \u2009<\u20090.0001) as the primary diagnosis. There was no difference in freedom from death or re\u2010transplantation (\n p<\/jats:italic>\n \u2009=\u20090.81) or early rejection (17.5 vs. 27.1%,\n p<\/jats:italic>\n \u2009=\u20090.17) between the two groups. EBLT patients had less airway dehiscence (0.0 vs. 1.2%,\n p<\/jats:italic>\n \u2009=\u20090.006) and less bronchiolitis obliterans (36.3 vs. 65.0%,\n p<\/jats:italic>\n \u2009=\u20090.001) during the period of follow\u2010up. On multivariable analysis, surgical technique was not an independent risk factor for survival (HR 0.99 [CI 0.68\u20131.38],\n p<\/jats:italic>\n \u2009=\u20090.92). For patients aged \u2264\u20095\u2009years, there was no difference in survival between EBLT and BSLT (\n p<\/jats:italic>\n \u2009=\u20090.97).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n EBLT is associated with less airway dehiscence and bronchiolitis obliterans than BSLT in children. There is no difference in freedom from death or re\u2010transplantation between the groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/petr.70139","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T04:00:13Z","timestamp":1752465613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["En\u2010Bloc Versus Bilateral Sequential Technique for Pediatric Lung Transplantation"],"prefix":"10.1111","volume":"29","author":[{"given":"Mohan M.","family":"John","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranay","family":"Nayi","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Rosenblum","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhadra","family":"Shashidharan","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Chai","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawwaz","family":"Shaw","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Children's Healthcare of Atlanta\/Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.08.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2020.12.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2014.09.004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2021-22"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.04.030"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2024.02.1372"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.03.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.optechstcvs.2023.04.002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.11.016"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:36:58Z","timestamp":1764679018000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,13]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/petr.70139"],"URL":"https:\/\/doi.org\/10.1111\/petr.70139","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,13]]},"assertion":[{"value":"2024-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70139"}}