Meta-Analysis: Prevalence and Incidence of Gastroparesis Following Lung or Heart Transplantation

Gastroparesis is a recognized complication after thoracic organ transplantation that impairs nutrition, medication absorption, and graft outcomes.

This study aimed to quantify the risk of gastroparesis following lung (LT) and combined heart-lung transplantation (HLT).

A systematic search of PubMed, Embase, Scopus, and Web of Science from inception to January 2025 identified studies reporting gastroparesis after LT or HLT in adult cohorts with objective diagnostic testing. Random-effects meta-analysis was used to pool prevalence and incidence, with subgroup analyses by transplant type, and diagnostic modality, and meta-regression asessing the effects of age and sex.

Twenty-one studies, including 2888 patients, met the inclusion criteria. The pooled prevalence of gastroparesis was 31.87% (95% CI: 19.88-46.87). Subgroup analysis revealed a higher prevalence of gastroparesis in combined HLT recipients (44.89%, 95% CI: 17.05-76.35) compared to LT only (26.95%, 95% CI: 15.46-42.68), though this difference was not statistically significant (p = 0.31). The overall incidence was 25.67% (95% CI: 15.07-40.41), with HLT recipients showing a higher incidence (35.79%, 95% CI: 20.73-54.29) than LT only (19.38%, 95% CI: 8.3-38.9).

Gastroparesis affects nearly one-third of thoracic transplant recipients, with a numerically higher burden after HLT transplantation. There was no association between age and gender and the prevalence of post-transplant gastroparesis.