Gastroesophageal reflux and altered motility in lung transplant rejection.

Journal Article (Journal Article;Review)

BACKGROUND: Lung transplantation has become an effective therapeutic option for selected patients with end stage lung disease. Long-term survival is limited by chronic rejection manifest as bronchiolitis obliterans syndrome (BOS). The aspiration of gastric contents has been implicated as a causative or additive factor leading to BOS. Gastroesophageal reflux (GER) and altered foregut motility are common both before and after lung transplantation. Further, the normal defense mechanisms against reflux are impaired in the allograft. Recent studies using biomarkers of aspiration have added to previous association studies to provide a growing body of evidence supporting the link between rejection and GER. Further, the addition of high-resolution manometry (HRM) and impedance technology to characterize bolus transit and the presence and extent of reflux regardless of pH might better identify at-risk patients. Although additional prospective studies are needed, fundoplication appears useful in the prevention or treatment of post-transplant BOS. PURPOSE: This review will highlight the existing literature on the relationship of gastroesophageal reflux and altered motility to lung transplant rejection, particularly BOS. The article will conclude with a discussion of the evaluation and management of patients undergoing lung transplantation at our center.

Full Text

Duke Authors

Cited Authors

  • Castor, JM; Wood, RK; Muir, AJ; Palmer, SM; Shimpi, RA

Published Date

  • August 2010

Published In

Volume / Issue

  • 22 / 8

Start / End Page

  • 841 - 850

PubMed ID

  • 20507544

Pubmed Central ID

  • PMC2911519

Electronic International Standard Serial Number (EISSN)

  • 1365-2982

Digital Object Identifier (DOI)

  • 10.1111/j.1365-2982.2010.01522.x


  • eng

Conference Location

  • England