Acid reflux surgery could help prevent rejection in lung transplant patients

(Loyola University Health System) A procedure to treat acid reflux could help prevent chronic rejection in lung transplant patients, according to a study published in the American College of Surgeons.
Source: EurekAlert! - Medicine and Health - Category: Global & Universal Source Type: news

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AbstractPurpose of ReviewThis narrative review focuses on the presentation, contributing factors, diagnosis, and treatment of non-acid reflux. We also propose algorithms for diagnosis and treatment.Recent FindingsThere is a paucity of recent data regarding non-acid reflux. The recent Porto and Lyon consensus statements do not fully address non-acid reflux or give guidance on classification. However, recent developments in the lung transplantation field, as well as older data in the general population, argue for the importance of non-acid reflux.SummaryExtrapolating from the Porto and Lyon consensus, we generally classify p...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
Gastroparesis is frequently identified following lung transplantation with incidence rates as high as 44%.1 Gastroparesis post lung transplant is of significant concern, as complications directly related to gastroparesis, specifically gastroesophageal reflux and aspiration, have been linked to the development of bronchiolitis obliterans syndrome (BOS), the primary cause of graft failure and the main cause of late morbidity and mortality following lung transplantation.1 The therapy for medically refractory post lung transplant gastroparesis represents a significant therapeutic challenge, as current therapies (such as botuli...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Research Correspondence Source Type: research
Lung transplantation is a high-risk, but lifesaving, procedure for patients with end-stage lung disease. Although 1-year survival is high, long-term survival is not nearly as high, due mainly to acute and chronic rejection. Bronchiolitis obliterans syndrome is the most common type of chronic rejection and often leads to poor outcomes. For this reason, esophageal testing in the lung transplant population has become a major issue, and this article discusses the evidence behind esophageal testing, the importance of esophageal dysmotility gastroesophageal reflux disease, both acidic and nonacidic reflux, and aspiration and the...
Source: Gastroenterology Clinics of North America - Category: Gastroenterology Authors: Source Type: research
Conclusion: Increased acid exposure on pretransplant reflux testing was associated with the development of BOS and CLAD, both measures of chronic allograft rejection, after lung transplantation, and may provide clinically relevant information to improve lung allograft survival through aggressive reflux management.
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research
Gastroesophageal reflux disease (GERD) is a risk factor for chronic lung allograft dysfunction. Bile acids —putative markers of gastric microaspiration—and inflammatory proteins in the bronchoalveolar lavage (BAL) have been associated with chronic lung allograft dysfunction, but their relationship with GERD remains unclear. Although GERD is thought to drive chronic microaspiration, the selection of p atients for anti-reflux surgery lacks precision. This multicenter study aimed to test the association of BAL bile acids with GERD, lung inflammation, allograft function, and anti-reflux surgery.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL CLINICAL SCIENCE Source Type: research
Gastroesophageal reflux disease (GERD) is a risk factor for chronic lung allograft dysfunction (CLAD). The presence of bile acids —putative markers of gastric microaspiration—and inflammatory proteins in the bronchoalveolar lavage (BAL) has been associated with CLAD, but their relationship with GERD remains unclear. While GERD is thought to drive chronic microaspiration, selection of patients for anti-reflux surgery lacks precision. This multicenter study aimed to test the association of BAL bile acids with GERD, lung inflammation, allograft function, and anti-reflux surgery.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
This study examines the interaction of GERD and EsD on spirometry in LTRs.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (384) Source Type: research
Gastroparesis (GP) is prevalent after lung transplant (Ltx) (50-68%). GP has been associated with symptoms and delayed absorption of medications. Of particular concern after Ltx, GP can predispose to gastroesophageal reflux disease considered the main culprit for chronic allograft dysfunction. Therefore, early diagnosis and treatment is recommended in Ltx patients. Pharmacologic intervention for GP is not efficacious to improve gastric emptying and can induce potential serious side effects. Transcutaneous electric stimulation (TES) has been proposed to improve motility in various gastrointestinal motility disorders
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (786) Source Type: research
The pulmonary microbiome modulates the immune milieu in the lung allograft and is in turn influenced by external factors such as microaspiration of oropharyngeal contents. A potential driver of microaspiration is gastroesophageal reflux disease (GERD), which has been associated with poor outcomes after lung transplantation. We aimed to compare the pulmonary microbiome in lung transplant recipients with and without GERD, and correlate microbial composition with concurrent lung inflammation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (233) Source Type: research
Abstract CASE PRESENTATION: A 64-year-old man presented for consideration for lung transplant. He had a history of previous tobacco use, OSA on CPAP therapy, and gastroesophageal reflux disease. He worked as a design engineer. The patient had a 4-year history of dyspnea on exertion, followed with periodic CT scan of the chest. Nine months prior to his evaluation for lung transplant, the patient developed worsening of dyspnea, dry cough, poor appetite, and weight loss. At times, the cough was violent and associated with chest pressure. He was prescribed systemic corticosteroids and antibiotics without improvement. ...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
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