Chronic aspiration of gastric fluid accelerates pulmonary allograft dysfunction in a rat model of lung transplantation

Abstract

Chronic aspiration of gastric contents promotes accelerated allograft failure and may promote a profibrotic environment.

Assessing Oropharyngeal Dysphagia After Lung Transplantation: Altered Swallowing Mechanisms and Increased Morbidity

“…1,3,4 We hypothesized that repetitive microaspiration events are a contributing factor in lung allograft dysfunction, and recent data from other groups corroborate these assumptions. 5,13 In the present study, we have quantified the prevalence of new-onset oropharyngeal dysphagia and the attendant tracheal aspiration of thin liquids among patients who underwent formal swallowing evaluation after LT.…”

“…[1][2][3][4][5][6] Gastroesophageal reflux disease (GERD) is one of the most important contributors to non-immune allograft injury and appears to worsen after LT. 7 In addition, GERD is accompanied by BOS in clinical and laboratory settings, 1,3,5 but these changes are halted or prevented by fundoplication. 1,4 Furthermore, early fundoplication in patients leads to improved survival and freedom from BOS compared to those with GERD after LT who do not undergo fundoplication.…”

Gastro-oesophageal reflux and aspiration in patients with advanced lung disease

“…They found that exposure of the lung to filtered gastric aspirate induced fibrotic changes and severe acute rejection. 55 This model may be useful in elucidating the immunological covariates that affect the lung's response to aspiration.…”

721 Pepsin Concentrations Are Elevated in the Bronchoalveolar Lavage Fluid of Patients with Idiopathic Pulmonary Fibrosis after Lung Transplantation

“…Recent evidence has been increasingly convincing that aspiration of gastric contents is among the potential causative factors for the development of bronchiolitis obliterans syndrome (BOS) after lung transplantation [1][2][3][4][5][6][7][8][9]. The findings that support this hypothesis include that gastroesophageal reflux disease (GERD) is exceedingly common in lung transplant patients [2,3,10,11], that aspiration induces immunologic and inflammatory changes within the pulmonary allograft [9,12,13], and that lung transplant patients with GERD who undergo antireflux surgery have at least a stabilization of their pulmonary function, if not an improvement in their freedom from BOS [3][4][5][6].…”