Delayed gastric emptying scintigraphy in cystic fibrosis patients before and after lung transplantation.
BACKGROUND
The purpose of this study was to assess the rate of gastric emptying (GE) in cystic fibrosis patients scheduled for lung transplantation.


METHODS
Thirty patients (20 males, 10 females, 22.6 +/- 6.4 years) were evaluated by GE scintigraphy before (1.58 +/- 1.11 years) and early after (5.8 +/- 2.6 weeks) heart-lung transplantation (n = 13) or lung transplantation (n = 17). Solid retention rates at 2 hours (RR2) and 3 hours (RR3) and half-emptying times (T50) of solids and liquids obtained before transplantation were compared with those after transplantation. Data were also compared with those obtained from a control group of 53 healthy volunteers.


RESULTS
Before surgery, 20 patients (67%) showed a delayed GE (T50 of solids: patients 160.86 +/- 59.21 minutes vs controls 75.43 +/- 15.13 minutes, p < 0.0001), and 4 of them also had a delayed T50 of liquids. After surgery, the T50 of solids was considered unreliable (too much stasis) in 24 patients. Thus, analyses were done on the basis of solid retention rates. Twenty-nine patients (97%) showed very delayed GE compared with controls (p < 0.0001), 20 of whom also had a delayed T50 of liquids. RR2 and RR3 were significantly higher after surgery than before (RR2 = 86 +/- 17% and RR3 = 77 +/- 22% vs 50 +/- 24% and 27 +/- 24% after and before surgery, respectively, p < 0.0001). However, there was no correlation between pre- and post-transplantation scintigraphy results.


CONCLUSIONS
Delayed GE of solids was a frequent abnormality in patients with end-stage cystic fibrosis, with a dramatic delay after surgery in almost all patients. These results emphasize the need for early management of such patients by dietary manipulation or prokinetic medications.
Bodet-Milin
Caroline
C
Department of Nuclear Medicine, Hospital of the University of Nantes, Nantes, France.
Querellou
Solène
S
Oudoux
Aurore
A
Haloun
Alain
A
Horeau-Llanglard
Delphine
D
Carlier
Thomas
T
Bizais
Yves
Y
Couturier
Olivier
O
D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D004035:Diet Therapy; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D016041:Heart-Lung Transplantation / Q000502:physiology; D006801:Humans; D016040:Lung Transplantation / Q000502:physiology*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D011877:Radionuclide Imaging / Q000379:methods