Pediatric Lung Transplant Consensus Statement Published
Post Date: October 8, 2025 | Publish Date: Oct. 8, 2025
Cincinnati Children’s expert served as lead author
The International Society for Heart and Lung Transplantation (ISHLT) has published its first consensus statement laying out guidelines for referral criteria and selection of pediatric lung transplant candidates.
The society says the document is meant to assist pediatric care providers throughout the world caring for children with advanced lung diseases to identify potential candidates, optimize referral timing and to provide transplant centers with a framework for the evaluation and selection of children as candidates.
The statement, published Oct. 8, 2025, in the Journal of Heart and Lung Transplantation, was written by lead author Don Hayes, Jr., MD, MS, MEd, MBA, medical director of the Lung Transplant Program at Cincinnati Children’s.
Top take aways from the statement include:
- Children with advanced lung disease who are potential candidates for transplant should be referred to transplant centers early.
- Listing for transplantation for those with chronic, end-stage conditions should be considered when there’s a greater than 50% chance of mortality within two years.
- Optimizing pre-transplant care for children differs from adult care.
- In certain circumstances, listing for transplantation should be considered even in the cause of lung disease is unknown.
- Unmodifiable non-adherence, including refusal of recommended vaccinations, is considered a contraindication for pediatric lung transplantation.
- Given the scarcity of available organs, children needing multiple organ transplantation should be referred as early as possible.
“Previous ISHLT consensus documents on selecting lung transplant candidates were primarily adult-focused and provided limited pediatric-specific guidance,” Hayes says. “As a result, the pediatric lung transplant community felt that for the first time, an independent document entirely focused on children was needed.”
About pediatric lung transplantation
Lung transplantation for children is uncommon. Worldwide, only 2,777 procedures had ever been performed as of early 2024, according to the ISHLT. In the United States only 31 were performed in 2023.
One reason for the declining numbers of procedures has been dramatic improvements in treatment outcomes for people born with cystic fibrosis, which had been the leading reason for lung transplantation for children. Other causes include pulmonary vascular disorders like idiopathic pulmonary arterial hypertension (IPAH), congenital heart disease leading to lung dysfunction, and other conditions.
Cincinnati Children’s has been performing lung transplants since 2014. To date, the center has performed 31 procedures.
About Dr. Hayes
Hayes has published over 600 peer-reviewed articles, abstracts and book chapters. He also has delivered more than 170 presentations worldwide about lung disease.
The Hayes lab focuses on the role of the immune system in the lungs and how it contributes to the progression of lung disease and affects lung allografts in patients who have undergone a lung transplant.
He also serves on five editorial boards and as a member of numerous national organizations that focus on lung diseases.
Pulmonary medicine at Cincinnati Children’s
If your child has been diagnosed with a lung condition or pediatric lung disease, we are the right choice for care. Our division is one of the largest of its kind in the nation, and we were recently ranked the #2 Pulmonology and Lung Surgery program in the nation, according to U.S. News & World Report. Learn more.
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| Original title: | International Society for Heart and Lung Transplantation Consensus Statement on the Referral and Selection of Pediatric Lung Transplant Candidates |
| Published in: | Journal of Heart and Lung Transplantation |
| Publish date: | Oct. 8, 2025 |
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