Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2023; 29(21): 3292-3301
Published online Jun 7, 2023. doi: 10.3748/wjg.v29.i21.3292
Ineffective esophageal motility is associated with acute rejection after lung transplantation independent of gastroesophageal reflux
Wai-Kit Lo, Brent Hiramoto, Hilary J Goldberg, Nirmal Sharma, Walter W Chan
Wai-Kit Lo, Brent Hiramoto, Walter W Chan, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA 02115, United States
Hilary J Goldberg, Nirmal Sharma, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States
Author contributions: Chan WW and Lo WK initiated study concepts and design; Lo WK, Goldberg HJ, and Chan WW contributed to acquisition of data; Chan WW, Lo WK, Hiramoto B, Goldberg HJ, and Sharma N performed analysis and interpretation of data; Lo WK, Hiramoto B, and Chan WW drafted the manuscript; Chan WW, Lo WK, Hiramoto B, Goldberg HJ, and Sharma N contributed to critical revision of manuscript for important intellectual content; Chan WW and Lo WK performed statistical analyses; Chan WW provided administrative support and overall study supervision.
Institutional review board statement: The study was reviewed and approved by the Mass General Brigham Healthcare Institutional Review Board, No. 2011P001563.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: Lo WK, Hiramoto B, and Goldberg HJ, Sharma N-no relevant conflicts of interest for this article; Chan WW-Scientific Advisory Board (Takeda Pharmaceuticals, Phathom Pharmaceuticals, Sanofi Pharmaceuticals).
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Walter W Chan, AGAF, FACG, MD, Associate Professor, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States.
Received: March 5, 2023
Peer-review started: March 5, 2023
First decision: April 3, 2023
Revised: April 14, 2023
Accepted: April 28, 2023
Article in press: April 28, 2023
Published online: June 7, 2023
Core Tip

Core Tip: While gastroesophageal reflux (GER) has been associated with poorer outcomes after lung transplant, the impact of esophageal dysmotility remains unclear. Our study found that ineffective esophageal motility identified on pre-transplant esophageal manometry was independently associated with increased acute allograft rejection, even after adjusting for GER. This suggests that esophageal hypomotility may increase the risk of poor lung transplant outcome independent of GER. Routine esophageal function assessment should be considered in the peri-transplant evaluation of lung transplant patients to identify, risk stratify, and more effectively manage esophageal dysfunction in such patients at risk of poorer outcomes.