Esophageal Motility Disorders Associated With Death or Allograft Dysfunction After Lung Transplantation? Results of a Retrospective Monocentric Study

Pathological gastroesophageal reflux (GER) is a known risk factor for bronchiolitis obliterans syndrome (BOS) after lung transplantation. This study aimed at determining whether functional esophageal evaluation might predict BOS occurrence and survival in this setting. Ninety-three patients who unde...

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Bibliographic Details
Published in:Clinical and translational gastroenterology Vol. 11; no. 3; p. e00137
Main Authors: Gouynou, Célia, Philit, François, Mion, François, Tronc, François, Sénéchal, Agathe, Giai, Joris, Rabain, Anne-Marie, Mornex, Jean-François, Roman, Sabine
Format: Journal Article
Language:English
Published: United States Wolters Kluwer 01.03.2020
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
Nature Pub. Group
Subjects:
Adolescent
Adult
Aged
Allografts - pathology
Allografts - surgery
Bronchiolitis Obliterans - etiology
Bronchiolitis Obliterans - mortality
Bronchiolitis Obliterans - pathology
Bronchiolitis Obliterans - surgery
Computer Science
Cystic fibrosis
Disease
Esophageal diseases
Esophageal pH Monitoring
Esophagus
Esophagus - physiopathology
Female
Follow-Up Studies
Gastroesophageal reflux
Gastroesophageal Reflux - complications
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - epidemiology
Gastroesophageal Reflux - physiopathology
Graft Survival
Humans
Kaplan-Meier Estimate
Lung - pathology
Lung - surgery
Lung Transplantation - adverse effects
Male
Manometry
Mathematics
Medical prognosis
Middle Aged
Motility
Narcotics
Prevalence
Reoperation
Retrospective Studies
Risk Assessment
Risk Factors
Software
Statistics
Survival Rate
Transplantation, Homologous - adverse effects
Transplants & implants
Young Adult
ISSN:2155-384X, 2155-384X
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Summary:Pathological gastroesophageal reflux (GER) is a known risk factor for bronchiolitis obliterans syndrome (BOS) after lung transplantation. This study aimed at determining whether functional esophageal evaluation might predict BOS occurrence and survival in this setting. Ninety-three patients who underwent esophageal high-resolution manometry and 24-hour pH-impedance monitoring within the first year after lung transplantation were retrospectively included. A univariable analysis was performed to evaluate the parameters associated with GER disease and BOS occurrence. The Cox regression model was used to identify the prognostic factors of death or retransplantation. Thirteen percent of patients exhibited major esophageal motility disorders and 20% pathological GER. GER occurrence was associated with younger age, cystic fibrosis, and hypotensive esophagogastric junction. Within a median follow-up of 62 months, 10 patients (11%) developed BOS, and no predictive factors were identified. At the end of the follow-up, 10 patients died and 1 underwent retransplantation. The 5-year cumulative survival rate without retransplantation was lower in patients with major esophageal motility disorders compared with that in those without (75% vs 90%, P = 0.01) and in patients who developed BOS compared with that in those without (66% vs 91%; P = 0.005). However, in multivariable analysis, major esophageal motility disorders and BOS were no longer significant predictors of survival without retransplantation. Major esophageal motility disorders and BOS were associated with allograft survival in lung transplantation in the univariable analysis. Although the causes of this association remain to be determined, this observation confirms that esophageal motor dysfunction should be evaluated in the context of lung transplantation.
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ISSN:2155-384X
2155-384X
DOI:10.14309/ctg.0000000000000137