Most Read Articles
Stephen Padilla, 2 days ago
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
01 Aug 2020
Ensituximab, a chimeric monoclonal antibody targeting a variant of MUC5AC, shows modest clinical activity with good safety profile in patients with refractory colorectal cancer, according to data from a phase II study.
Roshini Claire Anthony, 30 Jul 2020

Frailty may indicate an increased risk of death from COVID-19, results of the COPE* study showed.

High acid exposure on reflux testing tied to chronic rejection after lung transplant

11 Jul 2020

Increased acid exposure on pretransplant impedance-pH testing may lead to the development of bronchiolitis obliterans syndrome (BOS) and chronic lung allograft dysfunction (CLAD), both of which are measures of chronic allograft rejection, after lung transplantation, suggests a recent study.

Such finding may offer clinically relevant information to improve lung allograft survival through aggressive reflux management, according to the investigators.

This retrospective cohort study included 51 lung transplant recipients (mean age, 56 years; 59 percent men) undergoing impedance-pH testing off proton pump inhibitor from 2007 to 2016. Those with pretransplant antireflux surgery were not eligible for the study.

Cox proportional hazards model was used for the time-to-event analysis to examine the relationship between pretransplant reflux measures and the development of BOS, which was defined histologically and clinically. A secondary analysis was conducted with CLAD as the outcome variable.

Over a mean follow-up of 2.2 years, 13 patients (28 percent) reached the BOS endpoint. Time-to-event analysis revealed that BOS correlated with elevated acid exposure, defined as >4.2 percent of time with pH <4 (hazard ratio [HR], 4.18, 95 percent confidence interval [CI], 1.31–13.4; p=0.01), and increased DeMeester score >14.7 (HR, 3.08, 95 percent CI, 1.02–9.26; p=0.04).

Kaplan-Meier analyses confirmed these associations.

On secondary analysis, increased acid exposure also correlated with CLAD (HR, 3.28, 95 percent CI, 1.09–9.88; p=0.03), which persisted on multivariate models.

“BOS is a primary measure of morbidity and mortality following lung transplantation and a manifestation of CLAD,” the investigators noted. “Acid reflux has been associated with early allograft injury through a proposed mechanism of aspiration and activation of the inflammatory cascade.”

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 2 days ago
The novel coronavirus disease (COVID-19) pandemic appears to have a significant impact on oncological care, according to a study, which stresses the need for psycho-oncological support for cancer patients.
01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
01 Aug 2020
Ensituximab, a chimeric monoclonal antibody targeting a variant of MUC5AC, shows modest clinical activity with good safety profile in patients with refractory colorectal cancer, according to data from a phase II study.
Roshini Claire Anthony, 30 Jul 2020

Frailty may indicate an increased risk of death from COVID-19, results of the COPE* study showed.