title: Reflux and allograft dysfunction: is there a connection?
abstract: Despite improving outcomes following lung transplantation, chronic rejection continues to limit survival. The predominant form of chronic rejection, bronchiolitis obliterans syndrome, has been associated with multiple etiologies including aspiration from gastroduodenal reflux. This article reviews the current literature with regards to the incidence of reflux following lung transplantation, the association of reflux with allograft dysfunction and survival, and the success of prevention and treatment of reflux in this patient population. Although antireflux surgery has been demonstrated to be safe in this population and leads to a stabilization of lung function in patients with reflux, there have not been definitive data that it improves survival.
authors.affiliation: Department of Surgery, Duke University Medical Center, 3443, Durham, NC 27710, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Gulack
authors.affiliation: Department of Surgery, Duke University Medical Center, 3443, Durham, NC 27710, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Meza
authors.affiliation: Department of Surgery, Duke University Medical Center, 3392, Durham, NC 27710, USA.
authors.forename: Shu S
authors.initials: SS
authors.lastname: Lin
authors.affiliation: Department of Surgery, Duke University Medical Center, 3863, Durham, NC 27710, USA.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Hartwig
authors.affiliation: Department of Surgery, Duke University Medical Center, 3864, Durham, NC 27710, USA. Electronic address: duane.davis@duke.edu.
authors.forename: R Duane
authors.initials: RD
authors.lastname: Davis
mesh_terms: D001989:Bronchiolitis Obliterans / Q000209:etiology; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D055031:Primary Graft Dysfunction / Q000209:etiology
keywords: Allograft dysfunction; Antireflux surgery; Bronchiolitis obliterans syndrome; Chronic lung allograft dysfunction; Fundoplication; Gastroduodenal aspiration; Gastroesophageal reflux disease; Lung transplantation