W1823 Aspiration of Gastric Components in Lung Transplant Recipients: Do Bile Acids Account for the Inflammatory Reaction?

Abstract

Of those with abnormal studies, median age was 40 yrs, 63% were male and 86% had a primary diagnosis of cystic fibrosis (n=19). Twelve of the 22 (54 %) with an abnormal pH study had ARS. Within the surgery cohort, median age was 44 yrs, 53% were male, 83% (n=10) had a primary diagnosis of cystic fibrosis and the average acid exposure time was 10%. The patients who had acidic reflux but declined Nissen also had an average acid exposure time of 10%. The average time from transplant to ARS was 34 months (std dev 12). The mean follow up post ARS was 11 months (std dev 9). Prior to ARS, there was no significant difference in lung function in those patients with reflux who had ARS versus those with reflux who did not have ARS. ARS did not improve lung function based on change in FEV1 or decrease the rate of decline in lung function over time. Additionally, ARS had no mortality benefit. Of the LTR with ARS, two died in follow up, two had progression of their lung disease and eight had no change. In those declining ARS, 1 died and the other nine had progression of disease at the same rate as the LTR with ARS. Conclusion: GER is highly prevalent among recipients of lung transplant. Our study found no benefit in anti-reflux surgery in lung transplant patients with documented reflux. The potential benefit of anti-reflux surgery in the lung transplant population is unclear and should be weighed against the risks of the procedure.