title: Reduction of lipid-laden macrophage index after laparoscopic Nissen fundoplication in cystic fibrosis patients after lung transplantation.
abstract: BACKGROUND
  Lipid-laden macrophage (LLM) index could be potentially useful in assessing gastroesophageal (GE) reflux and aspiration after lung transplantation (LT) in patients with cystic fibrosis (CF).
  
  
  METHODS
  A retrospective review of CF patients undergoing LT and/or laparoscopic Nissen fundoplication (LNF) from January 1, 2009, to December 31, 2011, was performed.
  
  
  RESULTS
  Seventeen CF patients (nine women), mean (± SD) age 27.9 ± 7.5 yr, underwent LT with mean (± SD) pre-transplant FEV(1) of 20.9 ± 5.0% predicted. Seventy percentage (12/17) of patients underwent LNF without complications within 1-2 wk of LT. After LT, but prior to antireflux surgery, there was no significant difference in the mean (± SD) baseline LLM index (154 ± 41 vs. 146 ± 51, p = NS) between patients who were to undergo LNF and patients who did not. After LNF, a significant reduction in the mean (± SD) LLM index occurred following the procedure (154 ± 41-74 ± 54, p < 0.0001) while each patient reported resolution of symptoms of GE reflux, whereas 40% (2/5) undergoing only medical treatment reported resolution of symptoms.
  
  
  CONCLUSIONS
  Significant reduction in the LLM index occurred after LNF in CF patients after LT that correlated with resolution of clinical symptoms of GE reflux.
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH 43205, USA. hayes.705@osu.edu
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.forename: Stephen
authors.initials: S
authors.lastname: Kirkby
authors.forename: Karen
authors.initials: K
authors.lastname: S McCoy
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Mansour
authors.forename: Medhi
authors.initials: M
authors.lastname: Khosravi
authors.forename: Heather
authors.initials: H
authors.lastname: Strawbridge
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000517:prevention & control; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy; D008055:Lipids / Q000032:analysis*; D016040:Lung Transplantation / Q000009:adverse effects*; D008264:Macrophages / Q000737:chemistry* / Q000166:cytology / Q000378:metabolism; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D008055:Lipids