Long-term outcomes after infant lung transplantation for surfactant protein B deficiency related to other causes of respiratory failure

ObjectiveTo determine if the outcomes of lung transplantation for infants with surfactant protein-B (SP-B) deficiency are unique.Study designFrom a prospective analysis to identify infants with genetic causes of surfactant deficiency, we identified 33 SP-B–deficient infants from 1993 to 2005, and, among those undergoing lung transplantation (n = 13), compared their survival, pulmonary function, and developmental progress with infants who underwent transplantation at <1 year of age for parenchymal lung disease (n = 13) or pulmonary vascular disease (n = 11).ResultsFive-year survival rates (∼50%, P = .3) and causes of death were similar for all three groups once the infants underwent transplantation. However, significant pretransplantation mortality decreased 5-year survival from listing to approximately 30% (P = .17). Pulmonary function, development of bronchiolitis obliterans, and school readiness were similar among the three groups. We detected anti SP-B antibody in serum of 3 of 7 SP-B–deficient infants and none of 7 SP-B–sufficient infants but could not identify any associated adverse outcomes.ConclusionsLong-term outcomes after infant lung transplantation for SP-B–deficient infants are similar to those of infants transplanted for other indications. These outcomes are important considerations in deciding to pursue lung transplantation for infants with disorders of alveolar homeostasis.