NDLI: Gastroesophageal reflux disease is associated with an increased rate of acute rejection in lung transplant allografts.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Shah, N. Force, S. D. Mitchell, P. O. Lin, E. Lawrence, E. C. Easley, K. Qian, J. Ramirez, A. Neujahr, D. C. Gal, A. Leeper, K. Pelaez, A.
Description	Country affiliation: United States Author Affiliation: Shah N ( Emory University School of Medicine, Atlanta, Georgia 30322, USA.)
Abstract	PURPOSE: Gastric fundoplication (GF) for gastroesophageal reflux disease (GERD) may protect against the progression of chronic rejection in lung transplant (LT) recipients. However, the association of GERD with acute rejection episodes (ARE) is uncertain. This study sought to identify if ARE were linked to GERD in LT patients. METHODS: This single-center retrospective observational study, of patients transplanted from January 1, 2000, to January 31, 2009, correlated results of pH probe testing for GERD with ARE (≥International Society for Heart and Lung Transplantation A1 or B1). We compared the rates of ARE among patients with GERD (DeMeester Score > 14.7) versus without GERD as number of ARE per 1,000 patient-days after LT. Patients undergoing GF prior to LT were excluded. RESULTS: The analysis included 60 LT subjects and 9,249 patient-days: 33 with GERD versus 27 without GERD. We observed 51 ARE among 60 LT recipients. The rate of ARE was highest among patients with GERD: 8.49 versus 2.58, an incidence density ratio (IDR) of 3.29 (P = .00016). Upon multivariate negative binomial regression modeling, only GERD was associated with ARE (IDR 2.15; P = .009). Furthermore, GERD was associated with multiple ARE (36.4% vs 0%; P < .0001) and earlier onset compared with patients without GERD: ARE proportion at 2 months was 0.55 versus 0.26 P = .004). CONCLUSION: In LT recipients, GERD was associated with a higher rate, multiple events, and earlier onset of ARE. The efficacy of GF to reduce ARE among patients with GERD needs further evaluation.
File Format	HTM / HTML
ISSN	00411345
e-ISSN	18732623
DOI	10.1016/j.transproceed.2010.05.155
Journal	Transplantation Proceedings
Issue Number	7
Volume Number	42
Language	English
Publisher	Elsevier
Publisher Date	2010-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Transplantation__semicolon__medicine Gastroesophageal Reflux Etiology Graft Rejection Epidemiology Lung Transplantation Adverse Effects Acute Disease Cytomegalovirus Infections Gastric Fundus Pathology Immunosuppressive Agents Therapeutic Use Lung Diseases Classification Surgery Immunology Retrospective Studies Transplantation, Homologous
Content Type	Text
Resource Type	Article
Subject	Transplantation Surgery

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