Lo WK, Flanagan R, Sharma N, Goldberg HJ, Chan WW. Pre-Lung transplant reflux testing demonstrates high prevalence of gastroesophageal reflux in cystic fibrosis and reduces chronic rejection risk. World J Transplant 2023; 13(4): 138-146 [PMID: 37388387 DOI: 10.5500/wjt.v13.i4.138]
Corresponding Author of This Article
Walter W Chan, MD, MPH, Associate Professor, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, United States. wwchan@bwh.harvard.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 18, 2023; 13(4): 138-146 Published online Jun 18, 2023. doi: 10.5500/wjt.v13.i4.138
Pre-Lung transplant reflux testing demonstrates high prevalence of gastroesophageal reflux in cystic fibrosis and reduces chronic rejection risk
Wai-Kit Lo, Ryan Flanagan, Nirmal Sharma, Hilary J Goldberg, Walter W Chan
Wai-Kit Lo, Ryan Flanagan, Walter W Chan, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States
Nirmal Sharma, Hilary J Goldberg, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, 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, Flanagan R, Goldberg HJ, and Sharma N performed analysis and interpretation of data; Lo WK, Flanagan R, and Chan WW drafted the manuscript; Chan WW, Lo WK, Flanagan R, Goldberg HJ, and Sharma N contributed to critical revision of manuscript for important intellectual content; Chan WW and Lo WK performed statistical analyses; and 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 (2011P001563).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: Guidelines of the STROBE statement have been adopted for this manuscript.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Walter W Chan, MD, MPH, Associate Professor, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, United States. wwchan@bwh.harvard.edu
Received: November 20, 2022 Peer-review started: November 20, 2022 First decision: March 15, 2023 Revised: March 22, 2023 Accepted: March 31, 2023 Article in press: March 31, 2023 Published online: June 18, 2023 Processing time: 207 Days and 22.4 Hours
ARTICLE HIGHLIGHTS
Research background
Gastroesophageal reflux is prevalent in chronic lung disease and can negatively impact lung transplant outcomes. However, the impact of pre-transplant reflux testing is not established in the cystic fibrosis (CF) population.
Research motivation
Routine reflux evaluation remains poorly standardized in lung transplantation, and this work contributes to the growing literature on the utility of reflux testing and timely management in lung transplant patients, especially those with CF.
Research objectives
To evaluate the impact of pre-transplant reflux testing on transplant outcomes in CF, as well as determining the prevalence of reflux in this patient population.
Research methods
This was a retrospective cohort study of CF patients that underwent lung transplantation at a tertiary referral center.
Research results
Lung transplant candidates with CF were less likely than those with other chronic lung diseases to undergo reflux testing. Pre-transplant reflux testing identified high prevalence of pathologic reflux in CF. Reflux testing was associated with decreased risk of chronic rejection.
Research conclusions
Pre-transplant reflux testing revealed high prevalence of pathologic reflux in CF patients and was associated with decreased risk of chronic lung allograft dysfunction.
Research perspectives
Systemic reflux testing may improve lung transplant outcomes in the CF population. Future research should focus on the implementation of standardized reflux evaluation and timely reflux management in lung transplantation, and its impact on transplant outcomes, particularly in patients with CF.
