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Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation.

Publication ,  Journal Article
Davis, RD; Lau, CL; Eubanks, S; Messier, RH; Hadjiliadis, D; Steele, MP; Palmer, SM
Published in: J Thorac Cardiovasc Surg
March 2003

OBJECTIVES: Bronchiolitis obliterans is the greatest limitation to the long-term applicability of lung transplantation. Although alloimmune events are important, nonimmune events, such as gastroesophageal reflux, might contribute to lung injury and the development of bronchiolitis obliterans syndrome. METHODS: We retrospectively studied the 396 patients who underwent lung transplantation at the Duke Lung Transplant Program from April 1992 to April 2002. Reflux was assessed for using an ambulatory 24-hour esophageal pH probe. RESULTS: Reflux assessment with an esophageal pH probe was obtained in 128 patients after lung transplantation. Abnormal pH study results were present in 93 (73%) patients. Forty-three patients underwent a surgical fundoplication. There was no in-hospital or 30-day mortality in the patients undergoing fundoplication. At the time of fundoplication, 26 patients met the criteria for bronchiolitis obliterans syndrome. After fundoplication, 16 patients had improved bronchiolitis obliterans syndrome scores, with 13 of these patients no longer meeting the criteria for bronchiolitis obliterans syndrome. In patients at least 6 months after lung transplantation and 6 months after fundoplication, the forced expiratory volume in 1 second improved by an average of 24% (mean forced expiratory volume in 1 second before fundoplication, 1.87 L; mean forced expiratory volume in 1 second after fundoplication, 2.19 L/sec; P <.0002). Overall actuarial survival was significantly better in patients who had either normal pH studies or who had fundoplication. CONCLUSIONS: Gastroesophageal reflux disease is very common after lung transplantation and appears to contribute to mortality and development of bronchiolitis obliterans syndrome. Fundoplication in lung transplant recipients with gastroesophageal reflux disease is associated with significant improvements in lung function, particularly if performed before the late stages of bronchiolitis obliterans syndrome.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

March 2003

Volume

125

Issue

3

Start / End Page

533 / 542

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Survival Analysis
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Middle Aged
  • Maximal Expiratory Flow Rate
  • Male
 

Citation

APA
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ICMJE
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Davis, R. D., Lau, C. L., Eubanks, S., Messier, R. H., Hadjiliadis, D., Steele, M. P., & Palmer, S. M. (2003). Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg, 125(3), 533–542. https://doi.org/10.1067/mtc.2003.166
Davis, R Duane, Christine L. Lau, Steve Eubanks, Robert H. Messier, Denis Hadjiliadis, Mark P. Steele, and Scott M. Palmer. “Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation.J Thorac Cardiovasc Surg 125, no. 3 (March 2003): 533–42. https://doi.org/10.1067/mtc.2003.166.
Davis RD, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, et al. Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003 Mar;125(3):533–42.
Davis, R. Duane, et al. “Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation.J Thorac Cardiovasc Surg, vol. 125, no. 3, Mar. 2003, pp. 533–42. Pubmed, doi:10.1067/mtc.2003.166.
Davis RD, Lau CL, Eubanks S, Messier RH, Hadjiliadis D, Steele MP, Palmer SM. Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation. J Thorac Cardiovasc Surg. 2003 Mar;125(3):533–542.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

March 2003

Volume

125

Issue

3

Start / End Page

533 / 542

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Homologous
  • Survival Analysis
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Middle Aged
  • Maximal Expiratory Flow Rate
  • Male