Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Objective: Gastroparesis (GP), common in patients undergoing lung transplantation (LTx) for end-stage lung disease, can affect quality of life and absorbency of immunosuppressants. In this study, we examined incidence and risk factors for GP post-LTx and assessed the safety and efficacy of botulinum toxin-A (BTX) for treatment of GP post-LTx.
Methods: We reviewed charts of patients who underwent LTx at our center from 01/1/2013–12/22/2015. The incidence of GP was evaluated by pre-LTx gastric scintigraphy (GES) and again 1-year post-LTx. Logistic regression methods were used to ascertain variables associated with GP at 1-year post-LTx. Efficacy of intervention for GP was assessed by symptom relief and by 2-hour retention on GES 1 year post-LTx.
Results: In total, 232 LTx patients with GES data were included. 56 patients (24.1%) had evidence of GP on GES post-LTx; only 8 of these patients (14.3%) had pre-LTx GP. 30/55 (54.5%) patients with symptomatic GP received treatment with pyloric BTX injection (n=5), balloon dilation (n=5), or both (n=20). A higher proportion of patients with post-LTx GP were patients undergoing lung retransplantation than those undergoing first-time LTx (p <0.001). Gastroesophageal reflux disease (GERD) treated medically (48.2%) or surgically (19.7%) was more common in patients with GP than in patients without (p=0.034). Of the 25 patients who received pyloric BTX injection at a mean of 196.3±153 days post-LTx, 19 (76.0%) were asymptomatic 1 year post-LTx. Mean 2-hour retention rates were 26±22.9% in treated patients compared to 50±22.2% in untreated patients with GP.
Conclusion: This large, single-center study with objective GES data shows the high incidence of post-transplant GP. GP was associated with retransplantation and GERD. Pyloric BTX injection may may ameliorate symptoms of GP post-LTx. Treatment algorithms for symptomatic GP in LTx patients must be better defined by multicenter prospective studies.
CITATION INFORMATION: Biswas Roy S., Davis M., Rodriguez F., Serrone R., Kang P., Ipsen T., Smith M., Bremner R., Huang J., Huang J. Gastroparesis after Lung Transplantation: A Single-Center Experience Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Biswas S, Davis M, Rodriguez F, Serrone R, Kang P, Ipsen T, Smith M, Bremner R, Huang J, Huang J. Gastroparesis after Lung Transplantation: A Single-Center Experience [abstract]. https://atcmeetingabstracts.com/abstract/gastroparesis-after-lung-transplantation-a-single-center-experience/. Accessed April 25, 2019.
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