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Lung transplantation
Prevalence of gastrointestinal dysmotility and complications detected by abdominal plain films after lung transplantation: a single-centre cohort study
  1. Henriette Heinrich1,
  2. Anne Neuenschwander2,
  3. Stefan Russmann3,
  4. Benjamin Misselwitz1,
  5. Christian Benden2 and
  6. Macé M Schuurmans2
  1. 1Division of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Switzerland
  2. 2Division of Pulmonary Medicine, University Hospital Zurich, Zurich, Switzerland
  3. 3Division of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Dr Macé M Schuurmans; mace.schuurmans{at}usz.ch

Abstract

Introduction and Aims Gastrointestinal (GI) complications such as gastric retention (GR) and constipation are common after lung transplantation (LT). Abdominal plain films (APFs) are a low-cost diagnostic tool to detect impaired GI function. The goal of our study was to assess the prevalence of GI pathology seen on APF in lung transplant recipients (LTRs) and to identify associated risk factors.

Methods Retrospective analysis of consecutive LTRs followed up between 2001 and 2013. Demographic, radiographic and clinical data were assessed.

Results 198 patients were included in the study, 166 thereof had more than 1 APF with a mean number of 5 APFs per patient. 163 patients had a detectable radiographic pathology on APF. The proportion of LTR with GR was highest among cystic fibrosis patients (48.5%). Multivariate regression analysis showed a significant association of diabetes with GR with a trend for age and use of opiates as risk factors. Similarly, female sex, advanced age and diabetes showed a trend to be associated with lower GI tract complications. Almost all patients had suffered from at least 1 episode of lower GI dysmotility during a median follow-up of 5.7 years. No clear correlation between GI events and the development of chronic lung allograft dysfunction could be identified.

Conclusions We found a statistically significant association of diabetes with GR and a progressive increase in the prevalence of GR over time after LT. Lower GI complications affected >80% of LTR and increased over time. Future studies correlating GI transit with APF findings are needed.

  • Lung Transplantation
  • Alpha1 Antitrypsin Deficiency
  • Cystic Fibrosis
  • Immunodeficiency

This is an Open Access article 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/

https://doi.org/10.1136/bmjresp-2016-000162

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    Footnotes

    • Contributors HH is responsible for concept/design, data analysis/interpretation, drafting article, critical revision of article and approval of article. AN is responsible for data analysis/interpretation, drafting article and data collection. SR is responsible for data analysis/interpretation and critical revision of article. BM is responsible for critical revision of article and approval of article. CB is responsible for critical revision of article and approval of article. MMS is responsible for concept/design, data analysis/interpretation, drafting article, critical revision of article and approval of article.

    • Funding This study received no funding but was supported by the Division of Pulmonary Medicine and Division of Gastroenterology and Hepatology, respectively.

    • Competing interests None declared.

    • Ethics approval Zuerich Ethics comittee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.