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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References
1. Basseri B, Conklin JL, Pimentel M, et al. Esophageal motor dysfunction and gastroesophageal reflux are prevalent in lung transplant candidates. Ann Thorac Surg. 2010; 90(5):1630-6.
2. Fisichella PM, Jalilvand A. The role of impaired esophageal and gastric motility in end-stage lung diseases and after lung transplantation. J Surg Res.2014; 186(1):201-6.
3. Berastegui C, Roman J, Monforte V, et al. Biomarkers of pulmonary rejection. Transplant Proc. 2013; 45(9):3163-9.
4. Ciriza de los Ríos C, García Menéndez L, Díez Hernández A, et al. Motility abnormalities in esophageal body in GERD: are they truly related to reflux? J Clin Gastroenterol. 2005;39(3):220-3.
5. Tang T, Chang JC, Xie A, et al. Aspiration of gastric fluid in pulmonary allografts: effect of pH. J Surg Res. 2013; 181(1):e31-8.
6. Sweet MP, Herbella FA, Leard L, et al. The prevalence of distal and proximal gastroesophageal reflux in patients awaiting lung transplantation. Ann Surg. 2006;244(4):491-7.
7. Khan MQ, Nizami IY, Khan BJ, et al. Lung transplantation triggered "jackhammer esophagus": a case report and review of literature. J Neurogastroenterol Motil. 2013; 19(3):390-4.
8. Fisichella PM, Davis CS, Shankaran V, et al. The prevalence and extent of gastroesophageal reflux disease correlates to the type of lung transplantation. Surg Laparosc Endosc Percutan Tech. 2012; 22(1):46-51.
9. Ciriza de los Ríos C, Canga Rodríguez-Valcárcel F, Castel de Lucas I, et al. How useful is esophageal high resolution manometry in diagnosing gastroesophageal junction disruption: Causes affecting this disruption and its relationship with manometric alterations and gastroesophageal reflux. Rev Esp Enferm Dig. 2014;106(1):22-9.
10. Kahrilas PJ, Bredenoord A, Fox M, et al; International High Resolution Manometry Working Group. The Chicago Classification of esophageal motility disorders, v3.0. Neurogastroenterol Motil. 2015;27(2):160-74.
11. DeMeester TR , Lafontaine E, Joelsson BE, et al. Relationship of a hiatal hernia to the function of the body of the esophagus and the gastresophageal junction. J Thorac Cardiovasc Surg 1981;82:547–58.
12. Stewart S, Fishbein MC, Snell GI, et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transplant. 2007;26(12):1229-42.
13. Bredenoord AJ, Hebbard G. Technical aspects of clinical high-resolution manometry studies. Neurogastroenterol Motil 2012;24(suppl 1):5-10.
14. Ciriza-de-Los-Ríos C, Canga-Rodríguez-Valcárcel F, Lora-Pablos D, et al. How the Body Position Can Influence High-resolution Manometry Results in the Study of Esophageal Dysphagia and Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2015;21(3):370-9.
15. Roman S, Kahrilas PJ, Boris L, et al. High-resolution manometry studies are frequently imperfect but usually still interpretable. Clin Gastroenterol Hepatol. 2011;9(12):1050-5.
16. Ruiz de León San Juan A, Ciriza de Los Ríos C, Pérez de la Serna Bueno J, et al. Practical aspects of high resolution esophageal manometry. Rev Esp Enferm Dig. 2017;109(2):91-105.
17. Fox MR, Bredenoord A. Oesophageal high-resolution manometry: moving from research into clinical practice. Gut. 2008;57:405-23.
18. Pandolfino JE, Ghosh SK, Zhang Q, et al. Quantifying EGJ morphology and relaxation with high-resolution manometry: a study of 75 asymptomatic volunteers. Am J Physiol Gastrointest Liver Physiol. 2006;290(5):G1033-40.
19. Bodger K, Trudgill N. Guidelines for oesophageal manometry and pH monitoring. British Society of Gastroenterology. Guidelines in Gastroenterology. 2006: 1-11.
20. Kuo B, Castell DO. Optimal dosing of omeprazole 40 mg daily: effects on gastric and oesophageal pH and serum gastrin in healthy controls. Am J Gastroenterol. 1996: 1532-8.
21. Griffin SM, Robertson AG, Bredenoord AJ, et al. Aspiration and allograft injury secondary to gastroesophageal reflux occur in the immediate post-lung transplantation period (prospective clinical trial). Ann Surg 2013.258(5):705-11; discussion 11-2.
22. Castor JM, Wood RK, Muir AJ, et al. Gastroesophageal reflux and altered motility in lung transplant rejection. Neurogastroenterol Motil. 2013; 22(8):841-50.
23. Blondeau K, Mertens V, Vanaudenaerde BA, et al. Gastro-oesophageal reflux and gastric aspiration in lung transplant patients with or without chronic rejection. Eur Respir J. 2008;31(4):707-13.
24. Tangaroonsanti A, Lee AS, Crowell MD, et al. Impaired Esophageal Motility and Clearance Post-Lung Transplant: Risk For Chronic Allograft Failure. Clin Transl Gastroenterol. 2017;8(6):e102.
25. Roman S, Kahrilas P. Management of spastic disorders of the esophagus. Gastroenterol Clin North Am. 2013;42(1):27-43.
26. Sato H, Takeuchi M, Takahashi K, et al. Nutcracker and jackhammer esophagus treatment: a three-case survey, including two novel cases of eosinophilic infiltration into the muscularis propria. Endoscopy. 2015; 47(9): 855-7.
27. Jafari J, Yazaki E, Woodland P, et al. Effect of Azithromycin on Esophageal Hypomotility (EH) and Prediction of Response by Esophageal Stimulations Tests During High Resolution Manometry. Gastroenterology. 2015;148(4):S-75.
28. Gulack BC, Meza JM, Lin SS, et al. Reflux and allograft dysfunction: is there a connection? Thorac Surg Clin. 2015; 25(1):97-105.
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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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