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Lung Transplantation, Gastroesophageal Reflux, and Fundoplication

Lookup NU author(s): Dr Andrew Robertson, Professor Christopher Ward, Professor Jeffrey Pearson, Emeritus Professor Paul Corris, Professor John Dark, Professor Michael Griffin

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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. (Ann Thorac Surg 2010; 89: 653-60) (C) 2010 by The Society of Thoracic Surgeons


Publication metadata

Author(s): Robertson AGN, Ward C, Pearson JP, Corris PA, Dark JH, Griffin SM

Publication type: Review

Publication status: Published

Journal: Annals of Thoracic Surgery

Year: 2010

Volume: 89

Issue: 2

Pages: 653-660

Print publication date: 22/01/2010

ISSN (print): 0003-4975

ISSN (electronic): 1552-6259

Publisher: ELSEVIER SCIENCE INC

URL: http://dx.doi.org/10.1016/j.athoracsur.2009.09.001

DOI: 10.1016/j.athoracsur.2009.09.001


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