Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients
Background: Gastroesophageal reflux disease (GERD) is highly prevalent after lung transplantation (LTx) and is suspected to favor the development of chronic lung allograft dysfunction (CLAD), almost of bronchiolitis obliterans syndrome (BOS) phenotype. The preventive effect of antireflux surgery (AR...
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2024-11-01
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| author | Abdulmonem Hamid Alexandre Vallée Sophie Rong Olivier Boche Sandra De Miranda Laurence Beaumont-Azuar Sylvie Colin de Verdière Dominique Grenet Marc Stern Benjamin Zuber Jerôme Devaquet Julien Fessler Julien De Wolf Ciprian Pricopi Matthieu Glorion Edouard Sage Jonathan Messika Antoine Magnan François Parquin Clément Picard Antoine Roux Olivier Brugière |
| author_facet | Abdulmonem Hamid Alexandre Vallée Sophie Rong Olivier Boche Sandra De Miranda Laurence Beaumont-Azuar Sylvie Colin de Verdière Dominique Grenet Marc Stern Benjamin Zuber Jerôme Devaquet Julien Fessler Julien De Wolf Ciprian Pricopi Matthieu Glorion Edouard Sage Jonathan Messika Antoine Magnan François Parquin Clément Picard Antoine Roux Olivier Brugière |
| author_sort | Abdulmonem Hamid |
| collection | DOAJ |
| description | Background: Gastroesophageal reflux disease (GERD) is highly prevalent after lung transplantation (LTx) and is suspected to favor the development of chronic lung allograft dysfunction (CLAD), almost of bronchiolitis obliterans syndrome (BOS) phenotype. The preventive effect of antireflux surgery (ARS) on BOS/CLAD onset in patients with GERD still remains debated. We compared the outcome (freedom from CLAD and graft survival) of patients with GERD with or without performed ARS (GERD-ARS and GERD-noARS groups) and those without GERD (noGERD group) in our LTx cohort. Methods: Data from 284 LTx recipients with available post-LTx pHmetry findings were reviewed (2001-2014). We focused on the outcome of 244 patients without CLAD at the date of pHmetry. Results: Among 244 stable patients at the date of pHmetry, 78 patients did not have GERD and 166 patients had GERD [41 with and 125 without ARS performed]). The mean DeMeester score was higher in the GERD-ARS group than GERD-noARS group (p = 0.03). An increase in donor-specific antibodies' mean fluorescence intensity values was observed only in GERD after LTx (M6 vs day 0, p < 0.0001; M12 vs day 0, p = 0.003). Freedom from CLAD at 3 years post-pHmetry/ARS was higher for GERD-ARS patients as compared to GERD-noARS patients (p = 0.002). Additionally, ARS was independently associated with a subsequent decreased risk of CLAD onset at 3 years in GERD patients (GERD-ARS vs GERD-noARS, p = 0.02 [Cox models]). ARS was safe in this series, with no surgery-related deaths. Conclusions: Our results suggested a preventive effect of ARS on CLAD onset in stable selected patients with GERD, with a beneficial medium-term effect. IRB approval number: IRB00012437 |
| format | Article |
| id | doaj-art-b0d2a276db6d4a39b43489899653423f |
| institution | OA Journals |
| issn | 2950-1334 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
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| spelling | doaj-art-b0d2a276db6d4a39b43489899653423f2025-08-20T02:12:42ZengElsevierJHLT Open2950-13342024-11-01610014510.1016/j.jhlto.2024.100145Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patientsAbdulmonem Hamid0Alexandre Vallée1Sophie Rong2Olivier Boche3Sandra De Miranda4Laurence Beaumont-Azuar5Sylvie Colin de Verdière6Dominique Grenet7Marc Stern8Benjamin Zuber9Jerôme Devaquet10Julien Fessler11Julien De Wolf12Ciprian Pricopi13Matthieu Glorion14Edouard Sage15Jonathan Messika16Antoine Magnan17François Parquin18Clément Picard19Antoine Roux20Olivier Brugière21Pneumology, Lung Transplantation Department, Foch Hospital, Suresnes, France; Collège de Médecine des hôpitaux de Paris (CMHP), Paris, FranceDepartment of Epidemiology, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FranceVisceral Surgery Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FranceThoracic Intensive Care Unit, Foch Hospital, Suresnes, FranceThoracic Intensive Care Unit, Foch Hospital, Suresnes, FranceAnesthesiology Department, Foch Hospital, Suresnes, FranceThoracic Surgery Department, Foch Hospital, Suresnes, FranceThoracic Surgery Department, Foch Hospital, Suresnes, FranceThoracic Surgery Department, Foch Hospital, Suresnes, FranceThoracic Surgery Department, Foch Hospital, Suresnes, France; Université Versailles Saint-Quentin-en, Yvelines, FranceThoracic Intensive Care Unit, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FranceThoracic Intensive Care Unit, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, France; Université Versailles Saint-Quentin-en, Yvelines, FrancePneumology, Lung Transplantation Department, Foch Hospital, Suresnes, France; CEA/DRF/Institut de Biologie François Jacob/Service de Recherches en Hémato-Immunologie Hôpital St-Louis, Paris, France; Corresponding author: Olivier Brugière, Pneumology, Lung Transplantation Department, Foch Hospital, Suresnes, France.Background: Gastroesophageal reflux disease (GERD) is highly prevalent after lung transplantation (LTx) and is suspected to favor the development of chronic lung allograft dysfunction (CLAD), almost of bronchiolitis obliterans syndrome (BOS) phenotype. The preventive effect of antireflux surgery (ARS) on BOS/CLAD onset in patients with GERD still remains debated. We compared the outcome (freedom from CLAD and graft survival) of patients with GERD with or without performed ARS (GERD-ARS and GERD-noARS groups) and those without GERD (noGERD group) in our LTx cohort. Methods: Data from 284 LTx recipients with available post-LTx pHmetry findings were reviewed (2001-2014). We focused on the outcome of 244 patients without CLAD at the date of pHmetry. Results: Among 244 stable patients at the date of pHmetry, 78 patients did not have GERD and 166 patients had GERD [41 with and 125 without ARS performed]). The mean DeMeester score was higher in the GERD-ARS group than GERD-noARS group (p = 0.03). An increase in donor-specific antibodies' mean fluorescence intensity values was observed only in GERD after LTx (M6 vs day 0, p < 0.0001; M12 vs day 0, p = 0.003). Freedom from CLAD at 3 years post-pHmetry/ARS was higher for GERD-ARS patients as compared to GERD-noARS patients (p = 0.002). Additionally, ARS was independently associated with a subsequent decreased risk of CLAD onset at 3 years in GERD patients (GERD-ARS vs GERD-noARS, p = 0.02 [Cox models]). ARS was safe in this series, with no surgery-related deaths. Conclusions: Our results suggested a preventive effect of ARS on CLAD onset in stable selected patients with GERD, with a beneficial medium-term effect. IRB approval number: IRB00012437http://www.sciencedirect.com/science/article/pii/S2950133424000946graft dysfunctionlung transplantationgastroesophageal refluxantireflux surgeryDSA |
| spellingShingle | Abdulmonem Hamid Alexandre Vallée Sophie Rong Olivier Boche Sandra De Miranda Laurence Beaumont-Azuar Sylvie Colin de Verdière Dominique Grenet Marc Stern Benjamin Zuber Jerôme Devaquet Julien Fessler Julien De Wolf Ciprian Pricopi Matthieu Glorion Edouard Sage Jonathan Messika Antoine Magnan François Parquin Clément Picard Antoine Roux Olivier Brugière Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients JHLT Open graft dysfunction lung transplantation gastroesophageal reflux antireflux surgery DSA |
| title | Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients |
| title_full | Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients |
| title_fullStr | Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients |
| title_full_unstemmed | Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients |
| title_short | Antireflux surgery for prevention of chronic lung allograft dysfunction (CLAD) onset after lung transplantation: The earlier the better before CLAD onset? A single-center series of 284 patients |
| title_sort | antireflux surgery for prevention of chronic lung allograft dysfunction clad onset after lung transplantation the earlier the better before clad onset a single center series of 284 patients |
| topic | graft dysfunction lung transplantation gastroesophageal reflux antireflux surgery DSA |
| url | http://www.sciencedirect.com/science/article/pii/S2950133424000946 |
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