Research Progress in Pediatric Lung Transplantation: A Bibliometric Analysis

Abstract

Background

Pediatric lung transplantation is considered to be an effective treatment for end-stage lung disease in children, and this study mainly conducts a bibliometric analysis in the field of pediatric lung transplantation.

Methods

We used the web of science databases to perform a bibliometric analysis of the progress of research in the field of pediatric lung transplantation from 1996 to 2024. In addition, we used VOSviewer software and the “bibliometrix” package in R to visualize and analyze the authors, countries, journals, institutions, and keywords of the literature.

Results

We identified 359 literature studies related to pediatric lung transplantation, which were cited 6,387 times by 1,400 journals. The journal with the highest number of average citations was the “New England Journal of Medicine,” while the journals with the highest number of publications were the “Journal of Heart and Lung Transplantation and Pediatric Transplantation.” The United States was the country with the highest number of publications (64.3%), followed by the United Kingdom (11.1%) and Canada (8.08%).

Conclusion

Research in the field of pediatric lung transplantation is currently on the rise, while research is still dominated by developed countries, with most developing countries in their infancy. Against the background of COVID-19 and global health challenges, the unique need for pediatric lung transplantation is becoming a trend.

Keyword

pediatric - transplantation - lung - quality of life

Introduction

Lung transplantation has become the mainstay of treatment for various end-stage lung diseases and pulmonary vascular diseases. In recent years, the success of adult lung transplantation has also affected pediatric lung transplantation, and improvements in surgical techniques and medical support have effectively extended the quality of life for children. Despite this, fewer lung transplants are performed in children than in adults at each lung transplant center worldwide. As of June 2018, the International Heart and Lung Transplant Association has registered 2,514 and 733 cases of lung transplantation and heart–lung transplantation in children, respectively.[1] [2] In addition, pediatric lung transplantation still faces problems and dilemmas that are similar or different from those in adults. These difficulties include but are not limited to, a shortage of donor's lungs, a mismatch between the size of the donor's lungs and the recipient's thoracic cavity, early rejection, infection, primary graft dysfunction (PGD), chronic graft immune dysfunction, and so on. In 1968, Cooley et al performed the first combined heart–lung transplantation on a 2-month-old child with complete atrioventricular septal defect and pulmonary hypertension, who survived for only 14 hours.[3] The University of Toronto first performed a lung transplant in 1987 for a 16-year-old child with familial pulmonary fibrosis.[4]

Bibliometrics is the qualitative and quantitative study of published articles based on mathematical and statistical methods and the prediction of potential research trends in the field.[5] It first originated in the 20th century and is widely used in literature analysis.[6] In the process of analysis, detailed information such as authors, institutions, countries/regions, journals, keywords, and citations of different articles can be obtained, and the connections between them can be scientifically analyzed and visualized so that researchers can intuitively and clearly understand the research progress in different disciplines.[7] [8] If articles are cited by one or more other articles at the same time, then the structure and characteristics of the discipline and literature represented by the research object can be analyzed, which can help to explore the internal connections between different kinds of literature.[9] At the same time, it is one of the ways to evaluate the research results of papers, and it is also one of the tools to investigate the progress of the discipline, reveal the current status of research, and guide future research.[10]

Although bibliometric articles have been published in the field of lung transplantation in the past,[8] [11] there is currently no analysis of the literature on pediatric lung transplantation. Therefore, this study mainly summarizes and bibliometric the original literature published in the field of pediatric lung transplantation between 1996 and 2024, and evaluates and discusses its research results, to clarify the trends and hotspots of research, to provide more clues and ideas for future research.

Method

Data Sources

Web of science (WOS) has been accepted by researchers in many fields as a high-quality electronic literature resource database, and it is considered to be the most suitable database for bibliometric analysis.[12] [13] [14] We searched for articles in the field of pediatric lung transplantation in the WOS Core Collection databases, including the Science Citation Index Expanded (SCIE) and the Social Sciences Citation Index (SSCI). We developed the following search strategies: TS = (“child^*” or “pediatrics” or “pediatric” or “juvenile^*” or “teenager^*” or “adolescent^*” or “infant^*” or “infancy” or “baby^*” or “nursling^*”) and TS = (“lung transplant^*” or “lung graft^*” or “pulmonary transplant^*” or “pulmonary graft^*” or “lung allograft^*” or “lung allotransplant^*”). Our research consists mainly of original articles and reviews. In addition, there are no restrictions on the language in which the article can be written. As the database is constantly updated, we conducted a search on September 2, 2024 and completed the literature collection within 24 hours to prevent potential bias.

Data Cleaning and Sorting

We retrieved a total of 2,692 articles, and two independent authors conducted a comprehensive review of the preliminarily selected articles based on title, abstract, keyword, and publication time span (January 1, 1996–September 2, 2024). Finally, a total of 2,333 articles that deviated from the research topic and belonged to the field of lung transplantation but did not involve children, and the articles on pediatric heart transplantation were deleted, and then the articles were deduplicated and screened one by one. Finally, only 359 valid original literature papers were retained. We exported and saved the literature information in text, which mainly included title, author, country/region, year of publication, institution, keywords, abstract, and references.

Research Tools

We used VOSviewer software (1.6.20) to draw the knowledge graph. VOSviewer could be used to display not only maps built with VOS mapping technology, but also maps built using multi-dimensional zoom technology, including label visualization, density visualization, cluster density visualization, and scatter visualization.[15] In addition, we used the “bibliometrix” package in R (4.4.1) for bibliometric analysis.

Results

Number of Publications

The 359 articles included in this study were from 25 countries, 301 institutions, and 1,488 authors, published in 94 journals, and cited a total of 6,387 citations from 1,400 journals. There are 320 original articles, accounting for 89.1%, and 39 reviews, accounting for 10.9%. [Fig. 1] shows the number of articles published in relation to the distribution of time. Overall, the global research activity in the field of pediatric lung transplantation has not been stable, and the fitting formula for the annual cumulative number of published papers is y = 0.6204 × ^1.9341, and the fitting degree is R² = 0.992.

Fig. 1 From 1996 to 2024, the annual number of publications and cumulative papers in the field of pediatric lung transplantation. The figure shows the number of annual publications and cumulative papers in the field of pediatric lung transplantation from 1996 to 2004, with the dotted line representing the fitting curve of the cumulative number of articles.

Author and Cited Author Analysis

A total of 1,488 authors have published in the field of pediatric lung transplantation, of which 22 have published 10 or more articles ([Supplementary Table S1], available in the online version). [Table 1] shows the top 10 authors with the highest number of publications, including the number of publications, the number of citations, the number of citations per article, the institution, and the H-index. Sweet has the highest number of published papers, with a total of 44 papers and a total of 1,099 citations, with an average of 24.98 citations per article, demonstrating its activity and influence in the field. Hayes et al also topped the list with 42 and 35 articles, respectively, and their average citations and H-index also indicate their importance in this field. According to the analysis, we found that there was a total of 4,787 cited authors, of which 22 were cited more than 30 times, and [Supplementary Table S2] (available in the online version) listed the top 10 highly cited authors, their citations, and affiliations. [Fig. 2A, B] shows the close collaboration of the author and cited authors, respectively.

Table 1 Top 10 authors with the most publications

Author	Documents	Citations	Average citation	H-index	Institution
Sweet, Suart C.	44	1,099	24.98	30	Washington University
Hayes, Don, Jr.	42	481	11.45	47	University of Cincinnati College of Medicine
Mallory, George B.	35	669	19.11	26	Baylor College of Medicine
Benden, Christian	28	677	24.18	45	Boston Children's Hospital
Goldfarb, Samuel B.	25	512	20.48	17	University of Minnesota Twin Cities
Schecter, Marc G.	24	424	17.67	14	Cincinnati Children's Hospital Medical Center
Aurora, Paul	22	674	30.64	49	Great Ormond Street Hospital for Children
Faro, Albert	19	401	21.11	25	Washington University
Visner, Gary A.	19	260	13.68	30	Boston Children's Hospital
Danziger-Isakov, Lara A.	18	348	19.33	18	University of Cincinnati

Fig. 2 Author and cited author network analysis in pediatric lung transplantation research. (A) shows the number of papers published by different authors and their interconnections, while (B) shows the number of citations and interconnections of cited authors. The larger the dot, the more articles have been published/cited by the author. The thicker the line, the stronger the connection between the authors.

Analysis of Journals

The distribution and citations of journals demonstrate the mainstream academic communication platforms in the field and their influence. There are 94 journals on pediatric lung transplantation, of which 33 have published two or more articles ([Supplementary Table S3], available in the online version). [Table 2] shows the top 10 journals of published documents. “Journal of Heart and Lung Transplantation” and “Pediatric Transplantation” were tied for the journal with the highest number of published articles with 72. Although the two journals are equal in terms of the number of articles, the former has a total of 1,753 citations and 24.35 average citations, which is much higher than the latter (982 citations and 13.64 average citations), indicating that the “Journal of Heart and Lung Transplantation” is more influential in this field. Other highly published journals include “Journal of Thoracic and Cardiovascular Surgery” (405 citations and 27 average citations), “Transplantation” (246 citations and 18.92 average citations), and “Journal of Pediatrics” (224 citations and 44.8 average citations). These journals are all concentrated in the JournaI Citation Reports (JCR) Q1, reflecting their high quality and recognition in the academic community. [Supplementary Table S6] (available in the online version) shows the citing journals and cited journals in the field of pediatric lung transplantation. Citing journals represent the frontier of knowledge in the field of pediatric lung transplantation and reflect the journal resources frequently cited by researchers in their latest studies. The collection of cited journals represents the knowledge base of this field and mainly reflects the core literature and classic theories of research in this field.

Table 2 The top 10 most published journals

Source	Documents	Citations	Average citation	JCR
Journal of Heart and Lung Transplantation	72	1,753	24.35	Q1
Pediatric Transplantation	72	982	13.64	Q3
Journal of Thoracic and Cardiovascular Surgery	15	405	27	Q1
Transplantation	13	246	18.92	Q1
Journal of Pediatrics	5	224	44.8	Q1
American Journal of Transplantation	13	206	15.85	Q1
Pediatric Pulmonology	25	203	8.12	Q1
New England Journal of Medicine	1	142	142	Q1
Annals of Thoracic Surgery	8	117	14.63	Q1
Lancet	2	100	50	Q1

Institutional Analysis

In the analysis of institutions, we found that there were 42 institutions that published more than 5 articles ([Supplementary Table S4], available in the online version), of which [Table 3] shows the information of the top 10 institutions with the most documents. “Washington University” tops the list of publications and influence with 71 articles and 1,650 citations. Following closely behind are “Texas Children's Hospital” and “Baylor College of Medicine,” which published 42 and 32 articles, respectively, with 683 and 589 citations, respectively.

Table 3 Top 10 institutions with the most publications

Organization	Documents	Citations
Washington University	71	1,650
Texas Children's Hospital	42	683
Baylor College of Medicine	32	589
Boston Children's Hospital	25	279
Nationwide Children's Hospital	23	266
Cincinnati Children's Hospital Medical Center	22	239
The Ohio State University College of Medicine	22	305
Children's Hospital of Philadelphia	21	398
Great Ormond Street Hospital for Children	21	439
St. Louis Children's Hospital	18	498

Country/Regions Analysis

Research in the field of pediatric lung transplantation is mainly in North America, Europe, and Asia ([Supplementary Table S5], available in the online version). The United States is in a leading position in this field, with 231 publications, the most partnerships, and the strongest academic influence (H-index is 69, G-index is 57, and M-index is 2.71), with a cumulative number of 4,328 citations. ([Table 4] shows the top 10 countries with the most documents). [Fig. 3] shows the number of publications in different countries or regions over time. [Fig. 4] illustrates the collaborative relationships between different countries or regions.

Table 4 Information on the top ten countries in terms of publication volume

Country	Documents	Citations	Total link strength	H-index	G-index	M-index	TC	NP
United States	231	4,328	69	57	73	2.71	14,027	819
England	40	1,095	51	23	37	1.10	1,435	62
Canada	29	594	48	19	26	1.06	963	77
Switzerland	26	445	45	15	22	0.83	608	40
Germany	25	425	30	14	25	0.74	891	72
Australia	18	284	16	13	20	0.72	468	40
Austria	12	380	42	12	17	0.67	468	17
Japan	12	71	2	12	16	0.67	316	43
France	10	49	2	5	7	0.33	83	46

Abbreviations: NP, Network Productivity; TC, Total Citations.

Fig. 3 Temporal distribution of pediatric lung transplantation publications by country (1996–2024). This heatmap illustrates the distribution of publications across various countries over time, spanning from 1996 to 2024. Each cell represents the number of publications each year for a specific country, with color intensity indicating publication frequency.

Fig. 4 International collaboration network in pediatric lung transplantation research. This chord diagram illustrates the international collaboration network in pediatric lung transplantation research. Each segment represents a country, with different colors corresponding to geographical regions. The connecting lines indicate collaborative links between countries, with thicker lines representing stronger or more frequent collaborations.

Keywords and Research Hotspots

Keywords reflect the main purpose of the research and the core of the article, and through the analysis of keywords, we can understand the research hotspots and trends in this field. We analyzed the keywords that appeared 10 times or more in the paper and plotted a network view for visualization, and [Fig. 5] shows the frequency of keywords over time, reflecting the focus of the research of the field in different time periods. [Fig. 6] illustrates the multi-level structure of the research topic through keyword connections and color classifications. The larger the dot, the more often the keyword appears; the thicker the connection, the more times the two keywords appear in the same document. The colors represent different research topics.

Fig. 5 Temporal distribution of keywords in pediatric lung transplantation research (1996–2024). This heatmap visualizes the temporal trends of key research topics in pediatric lung transplantation from 1996 to 2024. Each row represents a specific keyword, while each column corresponds to a publication year. The color intensity indicates the frequency of publications associated with each keyword each year, with warmer colors signifying higher frequencies.

Fig. 6 Keyword co-occurrence network in pediatric lung transplantation research. This network visualization displays the co-occurrence relationships between keywords in pediatric lung transplantation research, grouped into thematic clusters. Each node represents a keyword, and the connections indicate the frequency of co-occurrence between keywords in the same publications. Different colors represent distinct clusters, grouping keywords with similar themes or research areas.

Discussion

This article researched and included 359 clinical studies in the field of pediatric lung transplantation since 1996 based on the WOS database. Using a bibliometric approach and using VOSviewer software, we systematically evaluated information on publication trends, author contributions, journals, institutions, and countries in these articles. In addition, we also cluster and analyze keywords and research hotspots to analyze the research hotspots and frontiers in the field of pediatric lung transplantation. Although about 90 percent of transplant centers worldwide perform only < five pediatric lung transplants per year,[16] research in this field have not been constrained or stagnant, and a large number of scholars continue to conduct in-depth research in this field.

Between 2005 and 2015, the number of publications worldwide was relatively concentrated and showed an upward trend, which may be related to the rapid progress of medical technology and the increasing global attention to pediatric lung transplantation. Since 2015, the number of published papers has fluctuated slightly, but the overall number of papers has remained relatively high, indicating that the research enthusiasm in this field is still high. The most prominent change is that from 2018 to 2021, the number of publications in the field of pediatric lung transplantation first showed a concave decline, and then a sudden increase. This situation may be related to the spread and treatment of the Coronavirus.[17] [18] [19] At that time, children or adolescents had to face the possibility of lung transplants due to COVID-19 infection.[18] Similarly, children who have undergone a lung transplant may also be susceptible to the coronavirus during this time due to weakened immunity. The novel coronavirus has had a fatal impact on older adults, adults with high BMI, and a range of underlying medical conditions such as diabetes and hypertension.[20] According to studies at the time,[21] COVID-19 deaths increased with age, and the average child had no symptoms or had mild symptoms. However, as the virus mutates and the vaccination of children is relatively slow, children with various chronic lung diseases (cystic fibrosis and asthma), congenital heart diseases (congenital pulmonary hypertension), and neurological conditions (cerebral palsy and convulsions) are at increased risk of contracting COVID-19 and resulting in death.[22] A meta-analysis suggests that[23] children with asthma have a higher probability of hospitalization after COVID-19 infection and that postlung transplantation and cystic fibrosis-associated diabetes mellitus are important factors contributing to the exacerbation of pneumonia in children with pulmonary cystic fibrosis. A case report describes a 16-year-old adolescent with a history of asthma who underwent a double lung transplant after developing COVID-19 and was stable and safely discharged.[17] Katharina reported the clinical manifestations and treatment outcomes of SARS-CoV-2 infection in 19 children who underwent lung transplantation, of which only one adolescent had serious complications due to superinfection. Children and adolescents are at less risk of severe COVID-19 than adults.[18] And several studies suggest that children and adolescents who have undergone lung transplants rarely develop severe COVID-19.[18] [24] [25] The impact of the pandemic was not one-sided, as the quantity and quality of donors began to decline, and testing donor lungs for SARS-CoV-2 infection and assessing donors for exposure to COVID-19 patients were also the focus of pediatric lung transplantation efforts at the time. Although antiviral or hormonal therapy can be given after lung transplantation, organs infected with patients with active SARS-CoV-2 pneumonia should be avoided.[24] A study in the United Kingdom showed that at the beginning of the pandemic, the number of donor donations in the United Kingdom fell by 48%, the utilization rate of donor lungs fell to 10 from 24% previously, and the number of lung transplants fell by 77%.[26] Not only in the United Kingdom but also in several European pediatrics transplant centers, the number of surgeries has been significantly reduced.[27] A study of the UNOS database showed that the number of pediatric lung transplants for all indications in the United States has gradually declined in recent years, especially after the COVID-19 pandemic, and this downward trend has been more pronounced and rapid.[28]

Benden et al have formed a wide network of academic collaborations in this field and maintain close contact with multiple researchers. Sweet et al form another collaborative group of authors who have increased the diversity and impact of their research through cross-institutional collaboration. Sweet et al have collaborated on numerous publications, and they have collaborated on infant lung transplantation,[29] pediatric lung retransplantation,[30] pediatric lung transplantation with cystic fibrosis.[31] They have participated in and produced reports on global lung transplantation.[32] [33] [34] [35] As can be seen from the diagram of the cooperative relationship of the cited authors ([Fig. 2B]), Benden et al at the center of the cited network and having a larger dot than other authors indicates that their research is more valuable to other scholars, and these core cited authors have also formed a close cooperative relationship to promote knowledge sharing and progress in the field of pediatric lung transplantation by co-authoring and citing each other's research results.

The journal with the highest number of average citations is “New England Journal of Medicine,” and there is one article published in the journal, titled “Lung Transplantation and Survival in Children with Cystic Fibrosis.”[36] This article retrospectively analyzes the factors affecting the survival rate of children with cystic fibrosis and discusses the benefits and harms of lung transplantation in children with cystic fibrosis. Journals such as “Journal of Heart and Lung Transplantation” and “American Journal of Roentgenology,” as cited journals, have established strong citation relationships with citing journals such as “Pediatric Pulmonology,” “Pediatric Transplantation,” and “European Respiratory Journal” through the bold paths, indicating that these knowledge bases have been widely used in cutting-edge research. Through the overlay analysis of citing and citing journals, we can clearly see the knowledge flow path and interdisciplinary integration trend in this field.

“Washington University,” “Texas Children's Hospital,” and “Baylor College of Medicine” are at the heart of the institution's collaborative network, forming an academic network with a strong radiating effect. This also indicates that the research on pediatric lung transplantation has formed a cooperative model centered on the core institutions and supplemented by peripheral institutions. In addition, the network also shows a trend toward international collaboration, such as the collaboration between the “Great Ormond Street Hospital for Sick Children” in the United Kingdom and several top children's hospitals in the United States, indicating cross-border academic exchanges in the field of pediatric lung transplantation. This increase in international cooperation also demonstrates the importance of pediatric lung transplantation as a global medical issue.

Since 1996, the number of publications in the United States has gradually increased, a trend that demonstrates not only the continued investment in this field in the United States, but also the long-term interest and ongoing exploration of lung transplant research in children ([Fig. 3]). The United States is not only far ahead in terms of the number of documents, but also has further expanded its influence through extensive international cooperation. The United States has established extensive partnerships with several European countries and Canada, forming a cross-continental research network. This shows that the United States occupies a significant leadership position and plays a key role in pediatric lung transplant research. European countries are also showing a growing interest in research and literature in this field at the beginning of the 21st century. These countries typically see research peaks in certain years, such as Germany with a higher volume of publications in 2006 and 2010, and Switzerland with significant contributions in 2008 and 2014 ([Fig. 3]). This trend may be related to the strengthening of European cooperation and the sharing of research resources in this field. The internal collaborations between European countries show strong regional synergies in European research on pediatric lung transplantation. Among them, 40 articles have been published in the United Kingdom, which has a high academic impact (H-index is 51) and has been cited 1,095 times ([Table 4]). Germany is a close second in terms of the number of articles and influence, with an H-index of 30. Other notable contributors include Canada and Switzerland, which have a modest number of documents but high citation rates and a respectable H-index. Although the number of publications in European countries is lower than in the United States, they still demonstrate a strong academic impact, and their high-quality research resonates with the global academic community. Asia, with Japan, South Korea, and China as the main representatives, has shown some growth in recent years in terms of the number of articles and citations, but there is still a gap between them and Europe and the United States in terms of the number of articles and citations. Japan dominates the region with 12 articles and 71 citations, while China and South Korea have relatively few research outputs, but still show some potential for growth. As interest in lung transplantation increases in the Asia–Pacific region, more literature output, and collaboration opportunities are likely to be seen in the future. Although literature output in the field of pediatric lung transplantation is mainly concentrated in developed countries, some developing countries such as Turkey, Argentina, and Brazil are also involved. Although the literature in these countries is small, they are gradually accumulating scientific resources and experience, and this diverse scientific research force will help to promote the comprehensive development of the field of pediatric lung transplantation worldwide.

In the early days (1996–2005), the research keywords mainly focused on topics such as “lung transplantation,” “transplantation,” “lung,” “children,” “pediatrics,” and other related keywords. As time went on (2006–2013), keywords such as “cystic fibrosis,”[37] [38] “heart–lung,”[39] “pulmonary arterial hypertension,”[40] [41] “immunosuppression,”[42] “bronchiolitis obliterans syndrome,”[43] and “mechanical ventilation”[44] gradually became the focus, and the research focus gradually shifted from the lung transplantation operation itself to answering a series of questions such as “Why do we need lung transplantation,” “What diseases are suitable for lung transplantation,” and “What are the complications after lung transplantation.” Nowadays (2014–2024), the keywords of research tend to be “survival,”[45] “rejection,”[46] “outcomes,” and “chronic lung allograft dysfunction.”[47] [48] Doctors are also paying more and more attention to the effect of surgery, the length of survival, and the quality of life of patients. Emerging keywords such as “COVID-19” and “ECMO”[49] [50] also show a focus on the special medical needs of lung transplant patients in the context of the global pandemic. We categorized the keywords into three categories. The red (related to immunity and rejection), including “immunosuppression,” “rejection,” “infections,” and “complications,” which reflected the importance of immune management and complication control after lung transplantation in children, and indicated the concern about posttransplant complications and immunotherapy. The green (related to surgery and long-term survival) mainly includes “mortality,” “survival,” “outcomes,” and “quality-of-life,” reflecting the focus on surgical outcomes, survival and mortality rates, and the quality of life of transplant children. The blue (supportive care and complication management) mainly includes “ECMO,” “mechanical ventilation,” “bridge,” and “life-support.” This theme focuses on the supportive care of children before and after lung transplantation. Control of immunity and rejection (red) is closely linked to surgical outcomes (green) and has a direct impact on long-term survival and quality of life. Supportive care (blue) provides critical physiological support before and after surgery to ensure the child's safety and stability during the transplant process. The relationship between these three themes comprehensively reflects the perioperative management of pediatric lung transplantation. These keywords among them also correspond to the theme keywords: “lung transplantation,” “children,” and “pediatrics lung.”

Limitation

There are still some limitations to our research. First, our data is mainly derived from the WOS database and does not refer to other databases, which can lead to insufficient data quantity. At the same time, with the update of the database, more articles in the field of pediatric lung transplantation will be published in the future. Second, we excluded articles in some formats such as books and letters. Also, due to the limited document type classification in the WOS database, our study did not distinguish between publication subtypes (e.g., case reports, RCTs, clinical guidelines). Future studies could address this issue by combining bibliometric data with manual full-text annotation. Finally, our analysis was mainly bibliometric and did not conduct further qualitative analysis of the content of the article.

Conclusion

In conclusion, we use bibliometric visualization to provide a comprehensive and systematic analysis of articles published in the field of pediatric lung transplantation between 1996 and 2024. Despite the limited number of pediatric lung transplant surgeries worldwide, research outcomes in this area continue to rise. Over time, the focus of research has shifted from the technical aspects of transplantation to more nuanced issues such as complications and quality of life. At present, only most developed countries and a few developing countries are involved in this field, and international cooperation should be further strengthened in the future. In the wake of COVID-19 and global health challenges, healthcare professionals will need to pay more attention to the unique needs of pediatric transplant patients in the future.

Conflict of Interest

None declared.

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Publication History

Received: 06 January 2025

Accepted: 11 March 2025

Article published online:
30 April 2025