Incidence and Risk Factors for Clinically Significant Oropharyngeal Dysphagia After Lung Transplantation

Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population. The aim of this retrospective, single-center study was to determine the incidence of clinically significant OPD in lung transplant recipients and to identify patient and procedural risk factors for OPD in this population. A total of 158 lung transplant recipients who underwent postoperative fiberoptic endoscopic evaluation of swallowing (FEES) were included in the study. The incidence of OPD was 67.1% (106/158) with 29.8% (47) having a complete absence of swallowing function. Female sex, cardiopulmonary bypass, duration of intubation, and an increased number of transesophageal echocardiography (TEE) clips were associated with OPD. The incidence of OPD in this study is consistent with the limited data available in lung transplant literature, and higher than that of general cardiac surgery. An increased number of acquired TEE clips is a novel OPD risk factor in this population and a modifiable target for future intervention.