| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2003;125:533-542
© 2003 The American Association for Thoracic Surgery
General Thoracic Surgery |
From the Departments of Surgerya and Pulmonary Medicine,b Duke University Medical Center, Durham, NC.
Read at the Eighty-second Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 6-8, 2002.
Received for publication May 10, 2002. Revisions requested July 17, 2002; revisions received Aug 29, 2002. Accepted for publication Sept 12, 2002. Address for reprints: R. Duane Davis, MD, Department of Thoracic Surgery, Duke University Medical Center, Box 3864, Durham, NC 27710 (E-mail: davis053{at}mc.duke.edu).
Objectives: Bronchiolitis obliterans is the greatest limitation to the long-term applicability of lung transplantation. Although alloimmune events are important, nonimmune events, such as gastroesophageal reflux, might contribute to lung injury and the development of bronchiolitis obliterans syndrome.
Methods: We retrospectively studied the 396 patients who underwent lung transplantation at the Duke Lung Transplant Program from April 1992 to April 2002. Reflux was assessed for using an ambulatory 24-hour esophageal pH probe.
Results: Reflux assessment with an esophageal pH probe was obtained in 128 patients after lung transplantation. Abnormal pH study results were present in 93 (73%) patients. Forty-three patients underwent a surgical fundoplication. There was no in-hospital or 30-day mortality in the patients undergoing fundoplication. At the time of fundoplication, 26 patients met the criteria for bronchiolitis obliterans syndrome. After fundoplication, 16 patients had improved bronchiolitis obliterans syndrome scores, with 13 of these patients no longer meeting the criteria for bronchiolitis obliterans syndrome. In patients at least 6 months after lung transplantation and 6 months after fundoplication, the forced expiratory volume in 1 second improved by an average of 24% (mean forced expiratory volume in 1 second before fundoplication, 1.87 L; mean forced expiratory volume in 1 second after fundoplication, 2.19 L/sec; P < .0002). Overall actuarial survival was significantly better in patients who had either normal pH studies or who had fundoplication.
Conclusions: Gastroesophageal reflux disease is very common after lung transplantation and appears to contribute to mortality and development of bronchiolitis obliterans syndrome. Fundoplication in lung transplant recipients with gastroesophageal reflux disease is associated with significant improvements in lung function, particularly if performed before the late stages of bronchiolitis obliterans syndrome.
This article has been cited by other articles:
|
|
 |
|
  K. Blondeau, V. Mertens, B. A. Vanaudenaerde, G. M. Verleden, D. E. Van Raemdonck, D. Sifrim, and L. J. Dupont Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection Eur. Respir. J., April 1, 2008; 31(4): 707 - 713. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Z. Tzeng, K. O. Leslie, D. Shelton, and A. Chan Unusual Dyspnea in a Woman With CREST Syndrome Chest, January 1, 2008; 133(1): 286 - 290. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Stovold, I. A. Forrest, P. A. Corris, D. M. Murphy, J. A. Smith, S. Decalmer, G. E. Johnson, J. H. Dark, J. P. Pearson, and C. Ward Pepsin, a Biomarker of Gastric Aspiration in Lung Allografts: A Putative Association with Rejection Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1298 - 1303. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Kempainen, K. Savik, T. P. Whelan, J. M. Dunitz, C. S. Herrington, and J. L. Billings High Prevalence of Proximal and Distal Gastroesophageal Reflux Disease in Advanced COPD Chest, June 1, 2007; 131(6): 1666 - 1671. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. O. Soubani and J. P. Uberti Bronchiolitis obliterans following haematopoietic stem cell transplantation Eur. Respir. J., May 1, 2007; 29(5): 1007 - 1019. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Bharat, R. C. Fields, E. P. Trulock, G. A. Patterson, and T. Mohanakumar Induction of IL-10 Suppressors in Lung Transplant Patients by CD4+25+ Regulatory T Cells through CTLA-4 Signaling J. Immunol., October 15, 2006; 177(8): 5631 - 5638. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Linden, R. J. Gilbert, B. Y. Yeap, K. Boyle, A. Deykin, M. T. Jaklitsch, D. J. Sugarbaker, and R. Bueno Laparoscopic fundoplication in patients with end-stage lung disease awaiting transplantation J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 438 - 446. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. G. Hartwig, J. Z. Appel, B. Li, C.-C. Hsieh, Y. H. Yoon, S. S. Lin, W. Irish, W. Parker, and R. D. Davis Chronic aspiration of gastric fluid accelerates pulmonary allograft dysfunction in a rat model of lung transplantation J. Thorac. Cardiovasc. Surg., January 1, 2006; 131(1): 209 - 217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Wilkes, T. M. Egan, and H. Y. Reynolds Lung Transplantation: Opportunities for Research and Clinical Advancement Am. J. Respir. Crit. Care Med., October 15, 2005; 172(8): 944 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. D'Ovidio, L. G. Singer, D. Hadjiliadis, A. Pierre, T. K. Waddell, M. de Perrot, M. Hutcheon, L. Miller, G. Darling, and S. Keshavjee Prevalence of Gastroesophageal Reflux in End-Stage Lung Disease Candidates for Lung Transplant Ann. Thorac. Surg., October 1, 2005; 80(4): 1254 - 1260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Davis Invited commentary Ann. Thorac. Surg., October 1, 2005; 80(4): 1260 - 1261. [Full Text] [PDF]
|
|
|
|
 |
|
 C Ward, I A Forrest, I A Brownlee, G E Johnson, D M Murphy, J P Pearson, J H Dark, and P A Corris Pepsin like activity in bronchoalveolar lavage fluid is suggestive of gastric aspiration in lung allografts Thorax, October 1, 2005; 60(10): 872 - 874. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. D'Ovidio, M. Mura, M. Tsang, T. K. Waddell, M. A. Hutcheon, L. G. Singer, D. Hadjiliadis, C. Chaparro, C. Gutierrez, A. Pierre, et al. Bile acid aspiration and the development of bronchiolitis obliterans after lung transplantation J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 1144 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. M. Verleden, L. J. Dupont, and D. E. Van Raemdonck Is it bronchiolitis obliterans syndrome or is it chronic rejection: a reappraisal? Eur. Respir. J., February 1, 2005; 25(2): 221 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Egan Obliterative Bronchiolitis after Lung Transplantation: A Repetitive Multiple Injury Airway Disease Am. J. Respir. Crit. Care Med., November 1, 2004; 170(9): 931 - 932. [Full Text] [PDF]
|
|
|
|
|
|
E. Cantu III, J. Z. Appel III, M. G. Hartwig, H. Woreta, C. Green, R. Messier, S. M. Palmer, and R. D. Davis Jr Early Fundoplication Prevents Chronic Allograft Dysfunction in Patients with Gastroesophageal Reflux Disease Ann. Thorac. Surg., October 1, 2004; 78(4): 1142 - 1151. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. L. Lau, G. A. Patterson, and S. M. Palmer Critical Care Aspects of Lung Transplantation J Intensive Care Med, March 1, 2004; 19(2): 83 - 104. [Abstract] [PDF]
|
|
|
|
|
|
C.L. Lau and G.A. Patterson Current status of lung transplantation Eur. Respir. J., November 16, 2003; 22(47_suppl): 57s - 64s. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. R. Young, D. Hadjiliadis, R. D. Davis, and S. M. Palmer Lung Transplantation Exacerbates Gastroesophageal Reflux Disease Chest, November 1, 2003; 124(5): 1689 - 1693. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
