J Neurogastroenterol Motil  https://doi.org/10.5056/jnm23017
Esophageal Motility Abnormalities in Lung Transplant Recipients With Esophageal Acid Reflux Are Different From Matched Controls
Mazen Elsheikh,1* Lekan Akanbi,2 Lisbeth Selby,3 and Bahaaeldeen Ismail3
1Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Department of Gastroenterology and Hepatology, University of Missouri Health Care, Columbia, MO, USA; and 3Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, KY, USA
Correspondence to: Mazen Elsheikh, MD
Department of Internal Medicine, Faculty of Medicine, Ain Shams University, 38 Abbasia, Cairo 11591, Egypt
Tel: +202-24346344, E-mail: Mazenmoussa@med.asu.edu.eg
Received: February 2, 2023; Revised: May 10, 2023; Accepted: July 7, 2023; Published online: December 8, 2023
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

Abstract
Background/Aims
There is an increased incidence of gastroesophageal reflux disease (GERD) after lung transplantation (LT) that can be associated with graft dysfunction. It is unclear if the underlying esophageal motility changes in GERD are different following LT. This study aimed to use esophageal high-resolution manometry (HRM) to explore GERD mechanisms in LT recipients compared to matched controls.
Methods
This was a retrospective study including patients with pathologic acid reflux who underwent HRM and pH testing at our healthcare facility between 7/2012 to 10/2019. The study included 12 LT recipients and 36 controls. Controls were matched in a 1:3 ratio for age, gender, and acid exposure time (AET).
Results
LT recipients had less hypotensive esophagogastric junction (EGJ) (mean EGJ-contractile integral 89.2 mm Hg/cm in LT vs 33.9 mmHg/cm in controls, P < 0.001). AET correlated with distal contractile integral and total EGJ-contractile integral only in LT group (r = −0.79, P = 0.002 and r = −0.57, P = 0.051, respectively).
Conclusions
Following LT, acid reflux is characterized by a less hypotensive EGJ compared to controls with similar AET. The strongest correlation with AET after LT was found to be esophageal peristaltic vigor. These results add to the understanding of reflux after LT and may help tailor an individualized treatment plan.
Keywords: Esophageal motility disorders; Gastroesophageal reflux; Lung diseases; Manometry


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