Incidence of Delayed Gastric Emptying Following Lung Transplantation.

Abstract

Purpose: To examine the impact of lung transplantation (Tx) on recipient gastric motility Methods: Adult recipients at a single center who had at least one Solid Gastric Emptying (SGE) study post-lung Tx, but prior to any GI intervention, were selected between June 2005 and August 2013. Multivariable logistic regression predicted risk factors for Delayed Gastric Emptying (DGE) after lung Tx. Subgroup analysis examined the impact of lung Tx on gastric emptying on 96 patients, who had SGE studies both pre and post Tx. Wilcoxon Signed Rank Test with Continuity Correction was used to analyze reduction in percent Gastric Emptying at various time points (60, 120 and 240 min). Results: 412 patients met study inclusion criteria. Of these, 236 (57.3%) had DGE after Tx. An underlining diagnosis of CF/Bronchiectasis (P= 0.0372) was a significant risk factor in predicting DGE after lung Tx. In the subgroup, DGE was noted in 12 patients (13%) pre-operatively, but increased to 61 patients (64%) after Tx. In the sub-analysis, percent reduction in solid gastric emptying after Tx was significant at all time points (60min: 10.1 % (P =0.001); 120min: 26.0% (P <0.001); 240 min: 25.3% (P<0.001)). Pre-operative DGE was a significant risk factor for post-operative DGE (p=0.003) on univariate analysis. Conclusions: DGE is very common following lung Tx, occurring in over half of lung recipients. The association with CF could be secondary to extra-pulmonary manifestations of the underlying disease, or indicative of increased vagal nerve injury perioperatively. DGE may play a role in the increased GERD-induced allograft injury seen after lung Tx. The impact of DGE on patient outcomes remains to be determined.Table 1: Patient DemographicsTable 2: % Reduction in Gastric Emptying at Various Time Points after Transplant