Morbidity and mortality of serious gastrointestinal complications after lung transplantation (original) (raw)
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Gastrointestinal Complications After Lung Transplantation
The Journal of Heart and Lung Transplantation, 2009
Background: Gastrointestinal complications after lung transplantation remain a common yet poorly defined problem. In this study we examine our experience with gastrointestinal complications after lung transplantation.
Clinical Transplantation, 2017
Physiologic changes in the gastrointestinal (GI) tract following lung transplantation are common and can lead to various complications that have been associated with substantial morbidity and mortality. 1-6 Furthermore, previous studies have demonstrated an association between gastro-esophageal reflux disease (GERD) and the development of bronchiolitis obliterans syndrome (BOS), a form of chronic lung allograft dysfunction (CLAD). 3,7 Delayed gastric emptying (DGE), another postoperative complication that has featured prominently in the lung transplantation literature, has been shown to increase the incidence of GERD, and perhaps may be indirectly responsible for CLAD. 8-10 This concern,
Abdominal Complications After Lung Transplantation in a Brazilian Single Center
Transplantation proceedings, 2017
Surgical and nonsurgical abdominal complications have been described after lung transplantation. However, there is limited data on this event in this population. The objective of this study was to analyze the incidence of abdominal complications in patients undergoing lung transplantation at the Heart Institute of the Faculty of Medicine, University of São Paulo (InCor-HCFMUSP) between the years 2003 and 2016. The main causes of abdominal complications were inflammatory acute abdomen (7 patients; 14%), obstructive acute abdomen (9 patients; 18%), gastroparesis (4 patients; 8%), distal intestinal obstruction syndrome (4 patients; 8%), perforated acute abdomen (7 patients; 14%), cytomegalovirus (CMV; 6 patients; 12%), and other reasons (12 patients; 26%). Separating these patients according to Clavien-Dindo classification, we had 21 patients (43%) with complications grade II, 4 patients (8%) with complications grade IIIa, 7 patients (14%) with grade IIIb complications, 7 patients (14%...
Surgery, 2010
Background-Gastroesophageal reflux disease (GERD) is thought to be a risk factor for the development or progression of chronic rejection after lung transplantation. However, the prevalence of GERD and its risk factors, including esophageal dysmotility, hiatal hernia and delayed gastric emptying after lung transplantation, are still unknown. In addition, the prevalence of Barrett's esophagus, a known complication of GERD, has not been determined in these patients. The purpose of this study was to determine the prevalence and extent of GERD, as well as the frequency of these risk factors and complications of GERD in lung transplant patients.
Lung Transplantation Exacerbates Gastroesophageal Reflux Disease *
Chest, 2003
Introduction: A high prevalence of gastroesophageal reflux (GER) has been reported in lung transplant recipients and is possibly linked to the development of bronchiolitis obliterans syndrome. The etiology of posttransplant GER remains unknown but may occur due to the transplant operation or posttransplant medications, or represent preexisting GER disease. We evaluated these possibilities by studying the nature and severity of GER in a cohort of patients before and after lung transplantation. Methods: Total, upright, and supine acid contact times were recorded in lung transplant recipients who underwent 24-h pH studies before and after transplantation. Patients also underwent esophageal manometry and gastric-emptying studies. Medications for acid suppression and gastric motility were discontinued before testing. Paired comparison between pretransplant and posttransplant results was performed using a paired t test. Results: Twenty-three patients were included in the analysis. The mean age was 51.5 years, and native diseases included emphysema (n ؍ 11), cystic fibrosis (n ؍ 4), pulmonary fibrosis (n ؍ 3), and others (n ؍ 5). Posttransplant studies occurred a median of 100 days after transplantation. After lung transplantation, the total acid contact time increased a mean of 3.7% (p ؍ 0.03) and the supine acid contact time increased a mean of 6.4% (p ؍ 0.019). Thirty-five percent (8 of 23 patients) had abnormal acid contact times before transplant, and 65% (15 of 23 patients) had abnormal acid contact after transplant. Changes in acid contact times were not explained by changes in esophageal or gastric motility. Only 20% (3 of 15 patients) with abnormal posttransplant pH studies were symptomatic. Conclusions: There is a significant increase in GER after lung transplantation, as measured objectively by 24-h pH studies, despite a lack of symptoms in most patients. Further research is needed to determine the physiologic mechanisms of posttransplant GER and its impact on long-term allograft function.
Digestive diseases and sciences, 1998
Giant gastric ulcers are defined as ulcers with a diameter greater than 3 cm. Previously they have not been described in lung transplant recipients. We report a high incidence of symptomatic giant gastric ulcers and identify the risk factors for ulcer development in these patients. We examined the records of all 95 patients who had undergone lung transplantation at our institution from November 1991 to July 1995. Fourteen of the patients who underwent lung transplantation developed symptoms that required esophagogastroduodenoscopy. Three of these patients (21%) were found to have giant gastric ulcers. The relative risk of giant gastric ulcer in symptomatic patients undergoing endoscopy after lung transplantation is over 40 times that of population controls. The patients who developed giant gastric ulcers, despite H2 antagonist use, had all received bilateral lung transplantation and had received nonsteroidal antiinflammatory drugs, cyclosporine, and high-dose intravenous corticoster...
Prevalence and Natural History of Barrett's Esophagus in Lung Transplant: A Single-Center Experience
The Annals of thoracic surgery, 2018
Barrett's esophagus (BE)-intestinal metaplasia in the esophagus-may progress to low-grade dysplasia (LGD), high-grade dysplasia (HGD), and ultimately, invasive esophageal adenocarcinoma (EAC). The course of BE in immunosuppressed lung transplant recipients is unknown. We retrospectively reviewed the records of patients who underwent lung transplant at our center between 01/01/2010 and 10/31/2016. We analyzed pre-transplant esophagram, esophagogastroduodenoscopy, 24-hour pH monitoring, high-resolution manometry, and gastric emptying studies. Of the 466 patients who underwent transplantation during the study period, 54 (11.59%) had BE on pre-transplant esophagogastroduodenoscopy. Of these, one patient had HGD pre-transplant. Median patient age was 64 years (interquartile range [IQR], 58.25-68.75) ; 66.6% were men. Median follow-up duration was 29.48 months (IQR, 19.69-37.98). 16/54 patients (29.62%) underwent antireflux surgery posttransplant. Three patients developed LGD or EAC d...