Clinical lung and heart/lung transplantationGastroesophageal Reflux (Symptomatic and Silent): A Potentially Significant Problem in Patients With Cystic Fibrosis Before and After Lung Transplantation
Section snippets
Methods
All patients with CF on the transplant waiting list and at least 2 months after bilateral sequential lung transplantation (LTx) for CF were invited to participate in a prospective study, which was approved by the Alfred Hospital ethics committee. All patients gave written informed consent for study participation. Patients with esophageal strictures or esophageal varices were excluded. Patients were investigated while off anti-reflux medication for at least 3 days (72 hours) during baseline
Results
A total of 24 patients were studied. In the group of patients on the lung transplant waiting list, the pre-LTx group, a total of 11 patients (6 males) completed the study. Thirteen patients (9 males) who underwent LTx for CF, and agreed to participate, formed the post-LTx group. One patient who initially agreed to be in the pre-LTx group was unable to tolerate the probe in situ for >30 minutes and had to be withdrawn from the study. No patients in the pre-LTx group were included in the post-LTx
Discussion
Before lung transplantation, factors such as chronic cough, hyperinflation, hyperalimentation, high-fat diet, overnight PEG feeds, delayed gastric emptying, postural drainage in head-down-tilted position and some medications may cause or exacerbate GER.4, 12, 14, 21 Alternatively, GER may cause cough and subsequent lung disease.14 Lung transplantation is widely accepted and practiced as a treatment modality for end-stage lung disease. The long-term outcomes remain limited, with 5-year survival
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