RT Journal Article
SR Electronic
T1 Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 707
OP 713
DO 10.1183/09031936.00064807
VO 31
IS 4
A1 K. Blondeau
A1 V. Mertens
A1 B. A. Vanaudenaerde
A1 G. M. Verleden
A1 D. E. Van Raemdonck
A1 D. Sifrim
A1 L. J. Dupont
YR 2008
UL http://erj.ersjournals.com/content/31/4/707.abstract
AB Acid gastro-oesophageal reflux (GOR) and gastric aspiration have been labelled as risk factors for chronic rejection bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). The present study aimed to further characterise GOR (both acid and nonacid) and the degree of gastric aspiration in LTx recipients both with and without BOS. Impedance-pH recordings were used for GOR detection. Pepsin and bile acid levels were measured in bronchoalveolar lavage fluid (BALF). A total of 48% of patients had increased GOR, of which 27% had exclusively increased nonacid reflux. Cystic fibrosis patients had the highest prevalence of GOR. Pepsin was found in BALF of all patients and bile acids in BALF of 50% of the patients. Patients with BOS had neither increased GOR nor elevated pepsin in BALF. However, 70% of the patients with BOS had bile in BALF compared with 31% of stable patients. Proton pump inhibitor (PPI) treatment reduced acid reflux but did not affect nonacid reflux. Moreover, pepsin and bile levels in BALF were not reduced by PPI. One-half of the lung transplant patients had increased reflux, and nonacid reflux was common. Gastric aspiration occurred in most lung transplant patients. Pepsin was a more general marker and bile acids a more specific marker that might be associated with bronchiolitis obliterans syndrome. Proton pump inhibitor treatment did not prevent nonacid reflux and gastric aspiration.