Symptomatic gastroesophageal reflux disease after lung transplantation.
OBJECTIVE
Gastroesophageal reflux disease (GERD) is associated with allograft dysfunction after lung transplantation (LTX). We attempted to identify outcomes in LTX recipients with clinical evidence of GERD.


METHODS
Retrospective review of 162 LTX recipients at our institution between January 1994 and June 2006 was performed. GERD was confirmed in symptomatic patients by esophagogastroduodenoscopy (EGD) and/or esophagography. Occurrence of biopsy-proven obliterative bronchiolitis (OB) and bronchiolitis obliterans syndrome (BOS) were analyzed. Kaplan-Meier analysis of survival and Cox proportional hazard analysis of risk factors were performed.


RESULTS
GERD was diagnosed in 21 (13%) of patients, usually following LTX (71%). There was no difference in mean survival (1603 +/- 300 vs. 1422 +/- 131 days; log rank P > 0.05), or development of OB (5% vs. 6%, respectively; P > 0.05) in patients with GERD compared with patients without GERD. However, there was correlation between GERD and BOS (P = 0.01).


CONCLUSIONS
Symptomatic GERD is increased following LTX. Patients with symptomatic GERD demonstrated an increased incidence of BOS, but survival was not affected in this study. More sensitive and specific diagnostic tools should be implemented in all LTX recipients to investigate the impact of symptomatic and silent GERD and thus improve outcomes after LTX.
Molina
Ezequiel J
EJ
Department of Cardiothoracic Surgery, Temple University School of Medicine, Philadelphia, PA, USA.
Short
Scott
S
Monteiro
Glen
G
Gaughan
John P
JP
Macha
Mahender
M
D000328:Adult; D001706:Biopsy; D001989:Bronchiolitis Obliterans / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D016145:Endoscopy, Digestive System; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013577:Syndrome; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome