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Reflux and allograft dysfunction: is there a connection?

Brian C Gulack¹, James M Meza¹, Shu S Lin²

¹Department of Surgery, Duke University Medical Center, 3443, Durham, NC 27710, USA.

Thoracic Surgery Clinics

|November 29, 2014

Summary

This summary is machine-generated.

Gastroesophageal reflux may contribute to chronic lung transplant rejection. While antireflux surgery is safe and stabilizes lung function, its impact on long-term survival remains unproven.

Keywords:

Allograft dysfunction Antireflux surgery Bronchiolitis obliterans syndrome Chronic lung allograft dysfunction Fundoplication Gastroduodenal aspiration Gastroesophageal reflux disease Lung transplantation

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Area of Science:

Medicine
Transplantation immunology
Gastroenterology

Background:

Chronic rejection, particularly bronchiolitis obliterans syndrome, remains a major challenge limiting long-term survival after lung transplantation.
Gastroduodenal reflux and subsequent aspiration are implicated as potential contributors to chronic lung allograft dysfunction.

Purpose of the Study:

To review the current literature on the incidence of gastroduodenal reflux post-lung transplantation.
To examine the association between reflux, allograft dysfunction, and patient survival.
To evaluate the efficacy of reflux prevention and treatment strategies in lung transplant recipients.

Main Methods:

Systematic literature review of studies investigating gastroduodenal reflux in lung transplant recipients.
Analysis of data on reflux incidence, correlation with lung allograft function, and survival outcomes.
Assessment of the safety and effectiveness of interventions for reflux management.

Main Results:

Gastroduodenal reflux is frequently observed following lung transplantation.
Reflux is associated with allograft dysfunction, though definitive links to survival are less clear.
Antireflux surgery is generally safe in this population and can stabilize lung function.

Conclusions:

Gastroduodenal reflux is a relevant factor in lung transplant recipients, potentially impacting allograft health.
While antireflux interventions show promise in stabilizing lung function, robust evidence demonstrating improved long-term survival is currently lacking.
Further research is needed to clarify the role of reflux in lung transplant outcomes and optimize management strategies.