Lung transplantation, gastroesophageal reflux, and fundoplication.

Abstract

Lung transplantation is an accepted treatment strategy for end-stage lung disease; however, bronchiolitis obliterans syndrome is a major cause of morbidity and mortality. This review explores the role of gastroesophageal reflux disease in bronchiolitis obliterans syndrome and the evidence suggesting the benefits of anti-reflux surgery in improving lung function and survival. There is a high prevalence of gastroesophageal reflux in patients post lung transplantation. This may be due to a high preoperative incidence, vagal damage and immunosuppression. Reflux in these patients is associated with a worse outcome, which may be due to micro-aspiration. Anti-reflux surgery is safe in selected lung transplant recipients; however there has been one report of a postoperative mortality. Evidence is conflicting but may suggest a benefit for patients undergoing anti-reflux surgery in terms of lung function and survival; there are no controlled studies. The precise indications, timing, and choice of fundoplication are yet to be defined, and further studies are required.

• Authors: Andrew G N Robertson, Chris Ward, Jeff P Pearson, Paul A Corris, John H Dark, S Michael Griffin
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 89 Issue 2 Pg. 653-60 (Feb 2010) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 20103377 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Bronchiolitis Obliterans (diagnosis, etiology, prevention & control)
• Child
• Fundoplication (methods)
• Gastroesophageal Reflux (complications, diagnosis, etiology, surgery)
• Humans
• Lung Transplantation
• Pneumonia, Aspiration (diagnosis, etiology, prevention & control)
• Postoperative Complications (diagnosis, etiology, prevention & control)