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Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux.

Publication ,  Journal Article
Hartwig, MG; Anderson, DJ; Onaitis, MW; Reddy, S; Snyder, LD; Lin, SS; Davis, RD
Published in: Ann Thorac Surg
August 2011

BACKGROUND: Gastroesophageal reflux disease (GERD) in lung recipients is associated with decreased survival and attenuated allograft function. This study evaluates fundoplication in preventing GERD-related allograft dysfunction. METHODS: Prospectively collected data on patients who underwent transplantation between January 2001 and August 2009 were included. Lung transplant candidates underwent esophageal pH probe testing before transplantation and surveillance spirometry evaluation after transplantation. Bilateral lung transplant recipients who had pretransplant pH probe testing and posttransplant 1-year forced expiratory volume in the first second of expiration (FEV1) data were included for analysis. RESULTS: Of 297 patients who met study criteria, 222 (75%) had an abnormal pH probe study before or early after transplantation and 157 (53%) had a fundoplication performed within the first year after transplantation. Patients with total proximal acid contact times greater than 1.2% or total distal acid contact times greater than 7.0% demonstrated an absolute decrease of 9.4% (±4.6) or 12.0% (±5.4) in their respective mean 1-year FEV1 values. Patients with abnormal acid contact times who did not undergo fundoplication had considerably worse predicted peak and 1-year FEV1 results compared with recipients receiving fundoplication (peak percent predicted=75% vs. 84%; p=0.004 and 1-year percent predicted=68% vs. 77%; p=0.003, respectively). CONCLUSIONS: Lung transplant recipients with abnormal esophageal pH studies attain a lower peak allograft function as well as a diminished 1-year FEV1 after transplantation. However a strategy of early fundoplication in these recipients appears to preserve lung allograft function.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2011

Volume

92

Issue

2

Start / End Page

462 / 468

Location

Netherlands

Related Subject Headings

  • Spirometry
  • Retrospective Studies
  • Respiratory System
  • Respiratory Insufficiency
  • Reoperation
  • Postoperative Complications
  • Patient Care Team
  • North Carolina
  • Middle Aged
  • Male
 

Citation

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ICMJE
MLA
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Hartwig, M. G., Anderson, D. J., Onaitis, M. W., Reddy, S., Snyder, L. D., Lin, S. S., & Davis, R. D. (2011). Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux. Ann Thorac Surg, 92(2), 462–468. https://doi.org/10.1016/j.athoracsur.2011.04.035
Hartwig, Matthew G., Deverick J. Anderson, Mark W. Onaitis, Shekur Reddy, Laurie D. Snyder, Shu S. Lin, and R Duane Davis. “Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux.Ann Thorac Surg 92, no. 2 (August 2011): 462–68. https://doi.org/10.1016/j.athoracsur.2011.04.035.
Hartwig MG, Anderson DJ, Onaitis MW, Reddy S, Snyder LD, Lin SS, et al. Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux. Ann Thorac Surg. 2011 Aug;92(2):462–8.
Hartwig, Matthew G., et al. “Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux.Ann Thorac Surg, vol. 92, no. 2, Aug. 2011, pp. 462–68. Pubmed, doi:10.1016/j.athoracsur.2011.04.035.
Hartwig MG, Anderson DJ, Onaitis MW, Reddy S, Snyder LD, Lin SS, Davis RD. Fundoplication after lung transplantation prevents the allograft dysfunction associated with reflux. Ann Thorac Surg. 2011 Aug;92(2):462–468.

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

August 2011

Volume

92

Issue

2

Start / End Page

462 / 468

Location

Netherlands

Related Subject Headings

  • Spirometry
  • Retrospective Studies
  • Respiratory System
  • Respiratory Insufficiency
  • Reoperation
  • Postoperative Complications
  • Patient Care Team
  • North Carolina
  • Middle Aged
  • Male