Lung Transplant Patient Knowledge of Gastroesophageal Reflux Disease and Foregut Risk Factors Associated With Graft...

Dysphagia, gastroesophageal reflux disease (GERD), and delayed gastric emptying (DGE) are foregut risk factors associated with worse lung transplant outcomes. Transplant education varies across centers, and patient awareness of these risk factors could impact treatment adherence and outcomes.

Pre- and post-lung transplant patients attending pulmonary rehabilitation between 01/2025-06/2025 were invited to complete a questionnaire developed by a multidisciplinary team to assess knowledge, perceived importance, and self-confidence in understanding the evaluation and management of foregut risks. Knowledge and confidence of disease factors were evaluated and assessed. Patient demographics, transplant history, and education preferences were collected. Comparisons were made between pre- and post-transplant groups using Chi-square tests for categorical measures.

Among 67 eligible patients, 48 (71.6%) completed the survey. There were no significant differences in age, sex, race, education level, or household income between pre- and post-transplant groups. Recognition of GERD as a risk factor for graft rejection was similar between pre- and post-transplant groups (24, 85.7% vs. 19, 95.0%; p = 0.30), as was overall confidence in understanding DGE as a risk factor (19, 67.9% vs. 13, 65.0%; p = 0.84). Respondents preferred to receive information on risks from the lung transplant team, but most (n = 28, 58.3%) patients indicated gastroenterologists should be most responsible for educating about and managing foregut risks.

Knowledge of foregut risks and corresponding confidence is high before and after transplant, which may reflect standardized education. Most patients preferred gastroenterology engagement in education on foregut disease, which is currently underutilized and could be an opportunity for multidisciplinary care.