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Gastroesophageal reflux disease in lung transplant recipients
Author(s) -
Hadjiliadis Denis,
Duane Davis R,
Steele Mark P,
Messier Robert H,
Lau Christine L,
Eubanks Steve S,
Palmer Scott M
Publication year - 2003
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1034/j.1399-0012.2003.00060.x
Subject(s) - medicine , gerd , lung transplantation , reflux , supine position , gastroenterology , transplantation , lung , disease
Abstract: Background: Chronic allograft dysfunction after lung transplantation contributes to poor long‐term survival. A link between gastric aspiration and post‐transplant lung dysfunction has been suggested, but little is known about the significance of gastroesophageal reflux disease (GERD) after lung transplantation. Methods: A retrospective study was performed to determine the prevalence of GERD in lung transplant recipients. Patients who underwent lung transplantation at Duke University, survived at least 6 months and had post‐transplant 24‐h pH studies were included in the analysis. Antireflux medications were discontinued prior to the pH study. Demographic data, pH study date and results, FEV 1 at the time of the pH study, confirmed acute rejection episodes, and current medications were collected. The FEV 1 ratio was calculated at the time of pH study (current FEV 1 /best post‐transplant FEV 1 ). Results: Forty‐three patients met entry criteria. Studies were performed at a median of 558 d post‐transplant. Thirty of forty‐three (69.8%) patients tested had abnormal total acid contact times (normal: <5%). The mean acid contact times for all patients were 10% total, 11.8% upright and 7.9% supine. A negative correlation was found between total or upright acid reflux and FEV 1 ratio at the time of studies (−0.341 and −0.419; p = 0.025 and p = 0.005, respectively). The effect of acid reflux on FEV 1 ratio remained significant after multivariable analysis. Conclusions: There is a high prevalence of GERD among selected lung transplant recipients who had pH studies performed and its presence is associated with worse pulmonary function. Future studies are needed to assess whether GERD contributes to the pathogenesis of bronchiolitis obliterans syndrome (BOS).