Gastric Motility Disorders Post Organ Transplantation-A Comprehensive Review.

Area of Science:

• Gastroenterology and Transplant Medicine

Background:

• Motility disorders, especially gastroparesis, are frequent and serious complications after solid organ transplantation.
• These conditions significantly impair patient quality of life, nutritional status, graft survival, and increase mortality risk.

Purpose of the Study:

• To comprehensively review the pathophysiology, clinical features, diagnosis, management, and prognosis of post-transplant gastroparesis.
• To synthesize evidence across various solid organ transplant types.

Main Methods:

• Systematic literature review of PubMed, Scopus, and Embase databases.
• Analysis of mechanisms including vagal nerve injury, immunosuppressants, surgical trauma, microbiome changes, and metabolic factors.
• Evaluation of diagnostic tools (gastric emptying scintigraphy, wireless motility capsules) and therapeutic strategies (prokinetics, G-POEM, gastric electrical stimulation, nutritional support).

Main Results:

• Lung transplant recipients have the highest prevalence (40-91%) and risk (2.7-fold increased mortality/retransplantation hazard) of gastroparesis.
• Post-transplant diabetes is a significant metabolic risk factor (OR 5.17 in kidney recipients).
• Effective management options include prokinetics (60-80% response), G-POEM (85% success), and gastric electrical stimulation (100% QoL improvement).

Conclusions:

• Gastroparesis poses a substantial threat to transplant recipients, particularly in thoracic and pediatric cases.
• Early screening, personalized interventions, and multidisciplinary care are crucial for mitigating complications and improving long-term transplant success.
• Future research should focus on microbiome therapies, AI predictive models, and wearable monitoring.