Anti-reflux surgery for gastroesophageal reflux disease after lung transplantation: Benefit for lung function, acute rejections and respiratory infections

Abstract

Introduction: Gastroesophageal reflux disease ( GERD) after lung transplantation (LT) is associated with chronic lung allograft dysfunction (CLAD). Anti reflux surgery (ARS) in LT need to be evaluated. Objective: To describe GERD occurrence in LT recipients and evaluate theeffect of ARS on lung allograft function. Material and Methods: We retrospectively reviewed charts of 284 LT patients who had esophageal pH monitoring between 1991 and 2014. GERD was defined as a deMeester score>14.7. For patients who underwent ARS (fundoplication), the incidence of acute rejections (AR) and respiratory infections (RI) were compared before and after surgery. At 6 months post-ARS FEV1 were considered either improved (>110% from baseline), stabilized (91-109%) or deteriorated ( Results: GERD was present in 199/284 patients (70%) who underwent testing at 4.5 months [3.1; 9.6] after LT. In the GERD group, the deMeester score was 44±29. GERD was more frequent in the cystic fibrosis patients (81%, vs 55% p Conclusion: Anti-reflux surgery for well chosen patients results in a decrease of AR, IR, and an improvement in pulmonary function.