The prevalence and extent of gastroesophageal reflux disease correlates to the type of lung transplantation.
BACKGROUND
Evidence is increasingly convincing that lung transplantation is a risk factor of gastroesophageal reflux disease (GERD). However, it is still not known if the type of lung transplant (unilateral, bilateral, or retransplant) plays a role in the pathogenesis of GERD.


METHODS
The records of 61 lung transplant patients who underwent esophageal function tests between September 2008 and May 2010, were retrospectively reviewed. These patients were divided into 3 groups based on the type of lung transplant they received: unilateral (n=25); bilateral (n=30), and retransplant (n=6). Among these groups we compared: (1) the demographic characteristics (eg, sex, age, race, and body mass index); (2) the presence of Barrett esophagus, delayed gastric emptying, and hiatal hernia; and (3) the esophageal manometric and pH-metric profile.


RESULTS
Distal and proximal reflux were more prevalent in patients with bilateral transplant or retransplant and less prevalent in patients after unilateral transplant, regardless of the cause of their lung disease. The prevalence of hiatal hernia, Barrett esophagus, and the manometric profile were similar in all groups of patients.


CONCLUSIONS
Although our data show a discrepancy in prevalence of GERD in patients with different types of lung transplantation, we cannot determine the exact cause for these findings from this study. We speculate that the extent of dissection during the transplant places the patients at risk for GERD. On the basis of the results of this study, a higher level of suspicion of GERD should be held in patients after bilateral or retransplantation.
Swallowing Center, Departments of Surgery, Division of Pulmonary and Critical Care Medicine, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois 60153, USA. marco6370@yahoo.com
Piero Marco
PM
Fisichella
Christopher S
CS
Davis
Vidya
V
Shankaran
James
J
Gagermeier
Daniel
D
Dilling
Charles G
CG
Alex
Elizabeth J
EJ
Kovacs
Raymond J
RJ
Joehl
Robert B
RB
Love
D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D001471:Barrett Esophagus / Q000209:etiology / Q000503:physiopathology; D003287:Contrast Media; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000503:physiopathology; D006551:Hernia, Hiatal / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D011859:Radiography; D019275:Radiopharmaceuticals; D012086:Reoperation; D012189:Retrospective Studies; D013671:Technetium Tc 99m Sulfur Colloid
D003287:Contrast Media; D019275:Radiopharmaceuticals; D001466:Barium Sulfate; D013671:Technetium Tc 99m Sulfur Colloid