Delayed Gastric Motility Post-Lung Transplantation in Patients With No Prior GI Surgery

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Delayed gastric emptying following lung transplantation may be directly related to increased incidence of gastroesophageal reflux disease.
Delayed gastric emptying following lung transplantation may be directly related to increased incidence of gastroesophageal reflux disease.

Patients undergoing lung transplantation often experience a host of physiologic changes in their gastrointestinal (GI) tracts. Researchers of a large, single-center, retrospective analysis published in Clinical Transplantation evaluated the occurrence of delayed gastric emptying (DGE) following lung transplantation.

A total of 412 patients who underwent primary lung transplantation between June 1, 2005, and August 31, 2013, were included in the study. All patients (median age, 59 years) had participated in ≥1 DGE study within 3 months post-transplantation, and none of the participants had a history of GI intervention (eg, pyloroplasty or fundoplication).

 

DGE was reported in 57% (236 of 412) of patients following transplantation. Multivariate analysis revealed that an underlying diagnosis of cystic fibrosis (CF) or bronchiectasis was a significant risk factor for the prediction of DGE and gastric dysmotility post-lung transplantation in patients with no prior GI surgery (adjusted odds ratio, 3.26). At 6 months post-transplantation, no survival difference was observed between patients with postsurgical DGE vs those without (log-rank test P =.0529).

The investigators concluded that DGE occurs frequently following lung transplantation, with more than half of all lung transplant recipients reporting the event. The association with CF might be secondary to extrapulmonary manifestations of underlying disease or it might be an indicator of increased intraoperative vagal nerve injury.

Study findings suggested that DGE may play a considerable role in the increased gastroesophageal reflux disease observed on pulmonary function tests following lung transplantation. More prospective studies are warranted to validate these conclusions.

Reference

Hirji SA, Gulack BC, Englum BR, et al. Lung transplantation delays gastric motility in patients without prior gastro-intestinal surgery - a single center experience of 412 consecutive patients [published online July 31, 2017]. Clin Transplant. doi:10.1111/ctr.13065

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