Related Experiment Video
Updated: Aug 15, 2025
07:28
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
402
Laparoscopic fundoplication after lung transplantation does not appear to alter lung function trajectory.
Adam Frankel1, Trina Kellar2, Farah Zahir3
1Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, The University of Queensland, Herston Queensland, Australia.
Summary
Laparoscopic fundoplication (LF) in lung transplant (LTx) recipients did not improve allograft function. This study found no significant changes in lung function after LF, with most patients experiencing a similar decline over time.
Area of Science:
- Pulmonology
- Transplant Surgery
- Gastroenterology
Background:
- Lung transplant recipients (LTx) often experience declining allograft function over time.
- Gastroesophageal reflux disease (GERD) is common in LTx patients and may impact allograft function.
- Laparoscopic fundoplication (LF) is a surgical procedure to treat GERD.
Purpose of the Study:
- To determine if laparoscopic fundoplication (LF) improves or stabilizes allograft function in lung transplant (LTx) recipients.
- To identify patient subgroups and predictive factors for improved respiratory outcomes after LF.
Main Methods:
- Retrospective analysis of 149 lung transplant recipients who underwent laparoscopic fundoplication between 2004 and 2018.
- Pulmonary function tests (PFTs), specifically forced expiratory volume in 1 second (FEV1), were collected pre- and post-LF.
- Statistical analysis included linear mixed models, random intercept models, and the Reliable Change Index (RCI).
Main Results:
- No statistically significant improvement in allograft function was observed after LF.
- Only one patient showed a significant improvement in lung function, while nine experienced a significant reduction based on RCI.
- The rate of FEV1 decline remained similar before and after LF for most patients.
Conclusions:
- Laparoscopic fundoplication does not appear to alter the natural decline in allograft function in lung transplant recipients.
- This large cohort study suggests LF is unlikely to reverse or halt functional decline in LTx allografts.
- Further research may be needed to identify specific patient profiles that could benefit from LF regarding respiratory outcomes.
