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.
Esophageal dysmotility and gastroesophageal reflux disease (GERD) are common in patients with advanced lung disease, and can potentially affect outcomes of lung transplant (LTx); however, the effects of LTx on foregut function remain unknown. We assessed foregut function before and after bilateral LTx.
Gastroesophageal reflux (GERD) is a frequent issue for patients with end-stage pulmonary disease,1-3 and its impact on outcomes for patients undergoing lung transplantation represents an important area of investigation. Among transplant recipients, GERD has been identified as a contributor to bronchiolitis obliterans syndrome and chronic pulmonary allograft dysfunction.4,5 The link between benign esophageal disease and end-stage lung failure touches on 2 key areas of clinical relevance for thoracic surgeons, taking the stage as a topic of significant interest in our specialty.
It’s hardly news that the gastrointestinal tract is important to human health: It transports food from the mouth to the stomach, converts it into absorbable nutrients and stored energy, and shuttles waste back out of the body. If you don’t properly nourish yourself, you don’t live. It’s that simple. But in recent years, scientists have discovered that the GI system has an even bigger, more complex job than previously appreciated. It’s been linked to numerous aspects of health that have seemingly nothing to do with digestion, from immunity to emotional stress to chronic illnesses, including can...
Conditions: Lung Transplant; GERD Intervention: Device: Reflux Band Sponsor: University of Florida Not yet recruiting
Gastroesophageal reflux disease (GERD) is prevalent after lung transplantation (LTx) and has been associated with allograft injury and chronic lung allograft dysfunction (CLAD) presumably through chronic microaspiration of bile acids and other gastric contents with subsequent innate immune activation. Anti-reflux surgery is widely used at some centers to treat GERD in LTx; however, its role in inflammation or aspiration is unknown. Our objective was to examine the effects of early anti-GERD surgery in LTx recipients on markers of microaspiration and inflammation in the bronchoalveolar lavage (BAL).
Gastroparesis and GERD are very common conditions in patients with end-stage lung disease and can be exacerbated after lung transplantation (LTx). At our center, we routinely test lung transplant recipients (LTRs) for gastric emptying abnormalities and for GERD at 3 months post-transplant. We hypothesized that LTRs with significant gastroparesis and/or GERD are more likely to develop lung injury leading to subsequent CLAD and death.
Gastroesophageal reflux disease (GERD) is thought to expose the lungs to refluxed gastric contents leading to injury and chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTRs). Prior small studies showed correlations between lung bile acids and CLAD/survival. The goal of this study was to determine whether bile acid levels in the bronchoalveolar lavage (BAL) correlate with GERD, concurrent lung allograft inflammation, or development of CLAD.
Conclusion: The type of LTx performed seems to lead to different risk factors for the development of o-CLAD. Physicians should be aware of these differences, as they may need to be taken into account when managing patient’s post-LTx.
Publication date: Available online 6 February 2019Source: The Lancet Respiratory MedicineAuthor(s): Peter M George, Caroline M Patterson, Anna K Reed, Muhunthan ThillaiSummaryIdiopathic pulmonary fibrosis (IPF) is a progressive lung disease with a poor prognosis. Lung transplantation is the only intervention shown to increase life expectancy for patients with IPF, but it is associated with disease-specific challenges. In this Review, we discuss the importance of a proactive approach to the management of IPF comorbidities, including gastro-oesophageal reflux, pulmonary hypertension, coronary artery disease, and malignancy. ...
European J Pediatr Surg Rep 2018; 06: e100-e103 DOI: 10.1055/s-0038-1675377Lung hypoplasia and pulmonary hypertension (PH) in association with congenital diaphragmatic hernia (CDH) may cause fatal respiratory failure. Lung transplantation (Ltx) may represent an option for CDH-related end-stage pulmonary failure. The aim of this study is to report a patient with CDH who underwent Ltx or combined heart-lung transplantation (H-Ltx). Our patient was born at 33 weeks of gestation, with a prenatally diagnosed isolated left CDH. Twenty-four hours after birth, she underwent surgical repair of a type D defect (according to the CDH ...