title: Prevalence of gastrointestinal dysmotility and complications detected by abdominal plain films after lung transplantation: a single-centre cohort study.
abstract: OBJECTIVE
  Gastrointestinal (GI) complications such as gastric retention (GR) and constipation are common after lung transplantation (LT). Abdominal plain films (APFs) are a low-cost diagnostic tool to detect impaired GI function. The goal of our study was to assess the prevalence of GI pathology seen on APF in lung transplant recipients (LTRs) and to identify associated risk factors.
  
  
  METHODS
  Retrospective analysis of consecutive LTRs followed up between 2001 and 2013. Demographic, radiographic and clinical data were assessed.
  
  
  RESULTS
  198 patients were included in the study, 166 thereof had more than 1 APF with a mean number of 5 APFs per patient. 163 patients had a detectable radiographic pathology on APF. The proportion of LTR with GR was highest among cystic fibrosis patients (48.5%). Multivariate regression analysis showed a significant association of diabetes with GR with a trend for age and use of opiates as risk factors. Similarly, female sex, advanced age and diabetes showed a trend to be associated with lower GI tract complications. Almost all patients had suffered from at least 1 episode of lower GI dysmotility during a median follow-up of 5.7 years. No clear correlation between GI events and the development of chronic lung allograft dysfunction could be identified.
  
  
  CONCLUSIONS
  We found a statistically significant association of diabetes with GR and a progressive increase in the prevalence of GR over time after LT. Lower GI complications affected >80% of LTR and increased over time. Future studies correlating GI transit with APF findings are needed.
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Henriette
authors.initials: H
authors.lastname: Heinrich
authors.affiliation: Division of Pulmonary Medicine , University Hospital Zurich , Zurich , Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Neuenschwander
authors.affiliation: Division of Clinical Pharmacology and Toxicology , University Hospital Zurich , Zurich , Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Russmann
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Misselwitz
authors.affiliation: Division of Pulmonary Medicine , University Hospital Zurich , Zurich , Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.affiliation: Division of Pulmonary Medicine , University Hospital Zurich , Zurich , Switzerland.
authors.forename: Macé M
authors.identifier: 0000-0001-5404-7566
authors.initials: MM
authors.lastname: Schuurmans
keywords: Alpha1 Antitrypsin Deficiency; Cystic Fibrosis; Immunodeficiency; Lung Transplantation