Gastroesophageal reflux disease after lung transplantation: pathophysiology and implications for treatment. Surgery 2010 Oct;148(4):737-44; discussion 744-5
Date
08/24/2010Pubmed ID
20727564Pubmed Central ID
PMC3066258DOI
10.1016/j.surg.2010.07.011Scopus ID
2-s2.0-77956652145 (requires institutional sign-in at Scopus site) 53 CitationsAbstract
BACKGROUND: Gastroesophageal reflux disease (GERD) is thought to be a risk factor for the development or progression of chronic rejection after lung transplantation. However, the prevalence of GERD and its risk factors, including esophageal dysmotility, hiatal hernia and delayed gastric emptying after lung transplantation, are still unknown. In addition, the prevalence of Barrett's esophagus, a known complication of GERD, has not been determined in these patients. The purpose of this study was to determine the prevalence and extent of GERD, as well as the frequency of these risk factors and complications of GERD in lung transplant patients.
METHODS: Thirty-five consecutive patients underwent a combination of esophageal function testing, upper endoscopy, barium swallow, and gastric emptying scan after lung transplantation.
RESULTS: In this patient population, the prevalence of GERD was 51% and 22% in those who had been retransplanted. Of patients with GERD,36% had ineffective esophageal motility (IEM), compared with 6% of patients without GERD (P = .037). No patient demonstrated hiatal hernia on barium swallow. The prevalence of delayed gastric emptying was 36%. The prevalence of biopsy-confirmed Barrett's esophagus was 12%.
CONCLUSION: Our study shows that, after lung transplantation, more than half of patients had GERD, and that GERD was more common after retransplantation. IEM and delayed gastric emptying are frequent in patients with GERD. Hiatal hernia is rare. The prevalence of Barrett's esophagus is not negligible. We conclude that GERD is highly prevalent after lung transplantation, and that delayed gastric emptying and Barrett's esophagus should always be suspected after lung transplantation because they are common risks factors and complications of GERD.
Author List
Davis CS, Shankaran V, Kovacs EJ, Gagermeier J, Dilling D, Alex CG, Love RB, Sinacore J, Fisichella PMAuthor
Christopher Stephen Davis MD, MPH Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultBarrett Esophagus
Female
Gastroesophageal Reflux
Humans
Lung Transplantation
Male
Middle Aged
Prevalence
Risk Factors
Young Adult
