Lung transplantation is currently performed on selected patients with end-stage lung disease. However, the median survival of patients after lung transplantation is inferior to that of any other solid organ transplantation, only 5 years.1 This low survival rate is primarily due to the development of obliterative bronchiolitis, which clinically manifests as bronchiolitis obliterans syndrome (BOS).2 BOS develops in almost half of lung transplant recipients within 5 years and is a source of considerable morbidity because of its detrimental effect on lung function and quality of life.1 The pathophysiology of obliterative bronchiolitis is not fully understood. However, evidence suggests that obliterative bronchiolitis might represent a nonimmunologic aberrant response to a chronic stimulus injury.3–6 Recently, gastroesophageal reflux disease (GERD) has been proposed as a potential factor responsible for chronic injury. Several studies have indirectly shown that the presence of GERD in lung transplant recipients is a risk factor for the development and progression of BOS, because of the high prevalence of GERD demonstrated after lung transplantation and because operative control of GERD may control the decline in lung function characteristic of BOS.4–7 Despite the evidence that supports the detrimental effect of GERD before and after lung transplantation, the prevalence of risk factors of GERD, including esophageal dysmotility, hiatal hernia, and delayed gastric emptying, are still unknown. In addition, the prevalence of Barrett’s esophagus, a known complication of GERD, has not been determined in lung transplant 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.
Full Text via ClinicalKey