title: Early outcomes of antireflux surgery for United States lung transplant recipients.
abstract: BACKGROUND
  This study aimed to evaluate early outcomes after antireflux surgery for lung transplant (LTx) recipients in the United States.
  
  
  METHODS
  Adult patients undergoing elective antireflux surgery between 2003 and 2008 were identified in the Nationwide Inpatient Sample. A propensity-matched analysis compared early outcomes between prior LTx recipients and well-matched control subjects consisting of non-LTx patients undergoing elective antireflux surgery during the same era. The primary outcome was inpatient mortality, and the secondary outcomes were hospital length of stay (LOS), perioperative complications, and hospital costs.
  
  
  RESULTS
  During the study period, 401 LTx recipients underwent elective antireflux surgery. These patients were well matched with 401 control patients in terms of age, sex, individual and overall comorbidity burden, hospital teaching status, hospital location, hospital antireflux volume, and open versus laparoscopic approach. The overall operative mortality rate was 1.4 %, with no difference between the groups. The overall and individual morbidity rates also were similar. The LOS and hospital costs were significantly greater in the LTx group. Multivariable logistic regression analysis confirmed that prior LTx did not confer an increased risk of inpatient mortality after antireflux surgery.
  
  
  CONCLUSIONS
  To date, this is the largest study to examine outcomes of antireflux surgery for LTx recipients. Operative mortality and morbidity appear to be comparable with those of the general population, although resource utilization is greater. Based on these data, trials to evaluate the role of antireflux surgery in preserving allograft function after LTx should not be hindered by a perceived notion of prohibitive operative risk in this patient population.
authors.affiliation: Department of Surgery, The Johns Hopkins Medical Institutions, Blalock 618, 600 N. Wolfe Street, Baltimore, MD 21287, USA. akilic1@jhmi.edu
authors.forename: Arman
authors.initials: A
authors.lastname: Kilic
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Shah
authors.forename: Christian A
authors.initials: CA
authors.lastname: Merlo
authors.forename: Christine G
authors.initials: CG
authors.lastname: Gourin
authors.forename: Anne O
authors.initials: AO
authors.lastname: Lidor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001989:Bronchiolitis Obliterans / Q000517:prevention & control; D016208:Databases, Factual; D017558:Elective Surgical Procedures / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000191:economics / Q000601:surgery*; D017721:Hospital Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery; D015983:Selection Bias; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult