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Ineffective esophageal motility is associated with acute rejection after lung transplantation independent of gastroesophageal reflux

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World Journal of Gastroenterology 2023年第21期29卷 3292-3301页

作者： Wai-Kit Lo brent hiramoto Hilary J Goldberg Nirmal Sharma Walter W Chan Division of Gastroenterology Hepatology and EndoscopyBrigham and Women's HospitalBostonMA 02115United States Division of Pulmonary and Critical Care Medicine Brigham and Women's HospitalBostonMA 02115United States

BACKGROUND Gastroesophageal reflux is associated with poorer outcomes after lung transplant,likely through recurrent aspiration and allograft *** prior studies have demonstrated a relationship between impedance-pH results and transplant outcomes,the role of esophageal manometry in the assessment of lung transplant patients remains debated,and the impact of esophageal dysmotility on transplant outcomes is *** particular interest is ineffective esophageal motility(IEM)and its associated impact on esophageal *** To assess the relationship between pre-transplant IEM diagnosis and acute rejection after lung *** This was a retrospective cohort study of lung transplant recipients at a tertiary care center between 2007 and *** with pre-transplant anti-reflux surgery were *** and reflux diagnoses were recorded from pre-transplant esophageal function ***-to-event analysis using Cox proportional hazards model was applied to evaluate outcome of first episode of acute cellular rejection,defined histologically per International Society of Heart and Lung Transplantation *** not meeting this endpoint were censored at time of post-transplant anti-reflux surgery,last clinic visit,or ***’s exact test for binary variables and student’s t-test for continuous variables were performed to assess for differences between *** Of 184 subjects(54%men,mean age:58,follow-up:443 person-years)met criteria for *** pulmonary fibrosis represented the predominant pulmonary diagnosis(41%).During the follow-up period,60 subjects(33.5%)developed acute *** all-cause mortality was 16.3%.Time-to-event univariate analyses demonstrated significant association between IEM and acute rejection[hazard ratio(HR):1.984,95%CI:1.03-3.30,P=0.04],confirmed on Kaplan-Meier *** multivariable analysis,IEM remained independently associated with acute rejection,even after c

关键词： Ineffective esophageal motility Esophageal hypomotility Esophageal manometry Gastroesophageal reflux disease Lung transplantation Acute rejection

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