Year 2018 / Volume 110 / Number 6
Original
Esophageal motor disorders are frequent during pre and post lung transplantation. Can they influence lung rejection?

344-351

DOI: 10.17235/reed.2018.5263/2017

Constanza Ciriza de los Ríos, Fernando Canga Rodríguez-Valcárcel, Alicia de Pablo Gafas, Isabel Castel de Lucas, David Lora Pablos, Gregorio Castellano Tortajada,

Abstract
Background: lung transplantation (LTx) is a viable option for most patients with end-stage lung diseases. Esophageal motor disorders (EMD) are frequent in candidates for LTx, but there is very little data about changes in esophageal motility post-LTx. Aim: the aim of our study was to assess esophageal motor disorders by high resolution manometry (HRM) both pre-LTx and six months post-LTx in patients with and without organ rejection. Study: HRM (Manoscan®) was performed in 57 patients both pre-LTx and six months post-LTx. HRM plots were analyzed according to the Chicago classification 3.0. Results: EMD were found in 33.3% and in 49.1% of patients pre-LTx and post-LTx, respectively, and abnormal peristalsis was more frequently found post-LTx (p = 0.018). Hypercontractile esophagus was frequently found post-LTx (1.8% and 19.3% pre-LTx and post-LTx, respectively). Esophagogastric junction (EGJ) morphology changed significantly pre-LTx and post-LTx; type I (normal) was more frequent post-LTx (63-2% and 82.5% respectively, p = 0.007). EMD were more frequent post-LTx in both the non-rejection and rejection group, although particularly in the rejection group (43.2% and 69.2% respectively, p = 0.09). EMD such as distal spasm, hypercontractile esophagus and EGJ outflow obstruction were also observed more frequently post-LTx in the rejection group. Conclusion: significant changes in esophageal motility were observed pre-LTx and particularly post-LTx; hypercontractile esophagus was a frequent EMD found post-LTx. EMD were more frequent in the group of patients that experienced organ rejection compared to the non-rejection group. EMD leading to an impaired esophageal clearance should be considered as an additional factor that contributes to LTx failure.
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Ciriza de los Ríos C, Canga Rodríguez-Valcárcel F, de Pablo Gafas A, Castel de Lucas I, Lora Pablos D, Castellano Tortajada G, et all. Esophageal motor disorders are frequent during pre and post lung transplantation. Can they influence lung rejection? . 5263/2017


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Publication history

Received: 15/09/2017

Accepted: 02/01/2018

Online First: 09/02/2018

Published: 31/05/2018

Article revision time: 103 days

Article Online First time: 147 days

Article editing time: 258 days


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