Transbronchial cryobiopsy is feasible and safe in children and adolescents

<bold>Background:</bold> Transbronchial cryobiopsy has evolved more and more into a standard method in adult pulmonology. Little is known about its use in pediatric patients. <bold>Aims and objectives:</bold> To report on our experiences with tansbronchial cryobiopsy in a pediatric setting <bold>Methods:</bold> Retrospective review of all transbronchial cryobiopsies we performed in our institution <bold>Results:</bold> 19 procedures were done in 16 patients, one patient was biopsied 4 times. The patients were 0.5-17.9 years old (mean 11.3, median 12.4 yrs). Indications for biopsy were surveillance or suspected rejection after lung transplantation in 9 cases, suspected interstitial lung disease in 7 cases and radiological findings of unknown etiology in 3 cases. All biopsies were done with the 1.9mm probe except one with the 1.1mm probe, a median of 3 samples were taken in each procedure. Of the 18 biopsies done with the 1.9mm probe, 17 have been analyzed, 1 result is pending. The diagnostic yield of the 17 biopsies was 88%. We could not get sufficient tissue material with the 1.1mm probe. Two patients (10.5%) got a pneumothorax which resolved spontaneously. 4 patients (21%) got a minor bleeding which was stopped with cold saline. 1 patient (5%) with acute rejection after lung transplantation (on oxygen before biopsy) was intubated and ventilated for 4 hours due a moderate bleeding and desaturation. 4 patients (21%) got a transient desaturation. In all 4 patients, a BAL was done simultaneously and 3/4 were on oxygen already before biopsy. <bold>Conclusions:</bold> Transbronchial cryobiopsy seems to be a feasible, effective and relatively safe method in children and adolescents. Diagnostic yield and complication rates are comparable with those in adults.