Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis
Introduction Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in...
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| Veröffentlicht in: | Surgical endoscopy 2025, Vol.39 (1), p.19-38 |
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| creator | Krahelski, Oliver Ali, Iihan Namgoong, Christopher Dave, Kavita Reed, Anna Ashrafian, Hutan Reddy, Marcus Khan, Omar Das, Bibek Fehervari, Matyas |
| description | Introduction
Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in lung transplant recipients.
Methods
In accordance with PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane library databases from inception until 13/01/2024. Articles reporting outcomes of ARS following lung transplantation were included. A random effects model was used for meta-analysis.
Results
The search identified 20 which were used for quantitative analysis. Overall, FEV1 and rate of change of FEV1 had improved following ARS by 0.141 L/s (95% CI; −02.82, −0.001) and −1.153 mL/d (95% CI; −12.117, −0.188), respectively. Survival hazard ratio post-ARS was 0.39 (95% CI; 0.19, 0.60). Nissen fundoplication was the most effective anti-reflux procedure with the greatest effect on reduction in the rate of change of FEV1, with an improvement of −2.353 mL/d (95% CI; −3.058, −1.649).
Conclusion
ARS in lung transplant recipients improves allograft function and survival. Given the increased incidence of GORD in lung transplant recipients, there should be a low threshold for investigation of GORD and subsequent ARS. |
| doi_str_mv | 10.1007/s00464-024-11392-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3132842830</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3148678301</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-5dd0ef23ac300bdd236c17387429c75fbba43131e47117b8de120aaf18e2f52f3</originalsourceid><addsrcrecordid>eNp9kcuO1DAQRSMEYpqBH2CBLLFhY_ArscMGoRGPkUZiA2vLSSoZj5K4cSU99F_wyVTTzfBYsLKle3xvlW9RPJXipRTCvkIhTGW4UIZLqWvF3b1iI41WXCnp7hcbUWvBla3NWfEI8UYQX8vyYXGm69JVzlab4vvlvEDewbzENIeRBbrwDP24fmNTmMMAE2msT5kNAZeceAJM22sSiD6BXUQICCzObFzngS05zLgdyYuINm4jWeBrFhjucYEpLLElYRfhlvI6NsESOGWNe4z4uHjQhxHhyek8L768f_f54iO_-vTh8uLtFW91WS287DoBvdKh1UI0Xad01UqrnTWqbm3ZN00wWmoJxkppG9eBVCKEXjpQfal6fV68Ofpu12aCrqURcxj9Nscp5L1PIfq_lTle-yHtvJRVVVkryOHFySGnryvg4qeILYy0N6QVPcUrZ5TTB_T5P-hNWjNtfKCMqyxBkih1pNqcEOlv76aRwh8a98fGPTXufzbuHT169uced09-VUyAPgJI0jxA_p39H9sfcR27PQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3148678301</pqid></control><display><type>article</type><title>Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Krahelski, Oliver ; Ali, Iihan ; Namgoong, Christopher ; Dave, Kavita ; Reed, Anna ; Ashrafian, Hutan ; Reddy, Marcus ; Khan, Omar ; Das, Bibek ; Fehervari, Matyas</creator><creatorcontrib>Krahelski, Oliver ; Ali, Iihan ; Namgoong, Christopher ; Dave, Kavita ; Reed, Anna ; Ashrafian, Hutan ; Reddy, Marcus ; Khan, Omar ; Das, Bibek ; Fehervari, Matyas</creatorcontrib><description>Introduction
Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in lung transplant recipients.
Methods
In accordance with PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane library databases from inception until 13/01/2024. Articles reporting outcomes of ARS following lung transplantation were included. A random effects model was used for meta-analysis.
Results
The search identified 20 which were used for quantitative analysis. Overall, FEV1 and rate of change of FEV1 had improved following ARS by 0.141 L/s (95% CI; −02.82, −0.001) and −1.153 mL/d (95% CI; −12.117, −0.188), respectively. Survival hazard ratio post-ARS was 0.39 (95% CI; 0.19, 0.60). Nissen fundoplication was the most effective anti-reflux procedure with the greatest effect on reduction in the rate of change of FEV1, with an improvement of −2.353 mL/d (95% CI; −3.058, −1.649).
Conclusion
ARS in lung transplant recipients improves allograft function and survival. Given the increased incidence of GORD in lung transplant recipients, there should be a low threshold for investigation of GORD and subsequent ARS.</description><identifier>ISSN: 0930-2794</identifier><identifier>ISSN: 1432-2218</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-024-11392-8</identifier><identifier>PMID: 39586876</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Bronchiolitis Obliterans - etiology ; Fundoplication - methods ; Gastroenterology ; Gastroesophageal reflux ; Gastroesophageal Reflux - etiology ; Gynecology ; Hepatology ; Humans ; Lung Transplantation ; Lung transplants ; Medicine ; Medicine & Public Health ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Proctology ; Review ; Review Article ; Surgery</subject><ispartof>Surgical endoscopy, 2025, Vol.39 (1), p.19-38</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>Copyright Springer Nature B.V. Jan 2025</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c356t-5dd0ef23ac300bdd236c17387429c75fbba43131e47117b8de120aaf18e2f52f3</cites><orcidid>0000-0002-0796-5150</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-024-11392-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-024-11392-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39586876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krahelski, Oliver</creatorcontrib><creatorcontrib>Ali, Iihan</creatorcontrib><creatorcontrib>Namgoong, Christopher</creatorcontrib><creatorcontrib>Dave, Kavita</creatorcontrib><creatorcontrib>Reed, Anna</creatorcontrib><creatorcontrib>Ashrafian, Hutan</creatorcontrib><creatorcontrib>Reddy, Marcus</creatorcontrib><creatorcontrib>Khan, Omar</creatorcontrib><creatorcontrib>Das, Bibek</creatorcontrib><creatorcontrib>Fehervari, Matyas</creatorcontrib><title>Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in lung transplant recipients.
Methods
In accordance with PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane library databases from inception until 13/01/2024. Articles reporting outcomes of ARS following lung transplantation were included. A random effects model was used for meta-analysis.
Results
The search identified 20 which were used for quantitative analysis. Overall, FEV1 and rate of change of FEV1 had improved following ARS by 0.141 L/s (95% CI; −02.82, −0.001) and −1.153 mL/d (95% CI; −12.117, −0.188), respectively. Survival hazard ratio post-ARS was 0.39 (95% CI; 0.19, 0.60). Nissen fundoplication was the most effective anti-reflux procedure with the greatest effect on reduction in the rate of change of FEV1, with an improvement of −2.353 mL/d (95% CI; −3.058, −1.649).
Conclusion
ARS in lung transplant recipients improves allograft function and survival. Given the increased incidence of GORD in lung transplant recipients, there should be a low threshold for investigation of GORD and subsequent ARS.</description><subject>Abdominal Surgery</subject><subject>Bronchiolitis Obliterans - etiology</subject><subject>Fundoplication - methods</subject><subject>Gastroenterology</subject><subject>Gastroesophageal reflux</subject><subject>Gastroesophageal Reflux - etiology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Lung Transplantation</subject><subject>Lung transplants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Review</subject><subject>Review Article</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kcuO1DAQRSMEYpqBH2CBLLFhY_ArscMGoRGPkUZiA2vLSSoZj5K4cSU99F_wyVTTzfBYsLKle3xvlW9RPJXipRTCvkIhTGW4UIZLqWvF3b1iI41WXCnp7hcbUWvBla3NWfEI8UYQX8vyYXGm69JVzlab4vvlvEDewbzENIeRBbrwDP24fmNTmMMAE2msT5kNAZeceAJM22sSiD6BXUQICCzObFzngS05zLgdyYuINm4jWeBrFhjucYEpLLElYRfhlvI6NsESOGWNe4z4uHjQhxHhyek8L768f_f54iO_-vTh8uLtFW91WS287DoBvdKh1UI0Xad01UqrnTWqbm3ZN00wWmoJxkppG9eBVCKEXjpQfal6fV68Ofpu12aCrqURcxj9Nscp5L1PIfq_lTle-yHtvJRVVVkryOHFySGnryvg4qeILYy0N6QVPcUrZ5TTB_T5P-hNWjNtfKCMqyxBkih1pNqcEOlv76aRwh8a98fGPTXufzbuHT169uced09-VUyAPgJI0jxA_p39H9sfcR27PQ</recordid><startdate>2025</startdate><enddate>2025</enddate><creator>Krahelski, Oliver</creator><creator>Ali, Iihan</creator><creator>Namgoong, Christopher</creator><creator>Dave, Kavita</creator><creator>Reed, Anna</creator><creator>Ashrafian, Hutan</creator><creator>Reddy, Marcus</creator><creator>Khan, Omar</creator><creator>Das, Bibek</creator><creator>Fehervari, Matyas</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0796-5150</orcidid></search><sort><creationdate>2025</creationdate><title>Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis</title><author>Krahelski, Oliver ; Ali, Iihan ; Namgoong, Christopher ; Dave, Kavita ; Reed, Anna ; Ashrafian, Hutan ; Reddy, Marcus ; Khan, Omar ; Das, Bibek ; Fehervari, Matyas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-5dd0ef23ac300bdd236c17387429c75fbba43131e47117b8de120aaf18e2f52f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Abdominal Surgery</topic><topic>Bronchiolitis Obliterans - etiology</topic><topic>Fundoplication - methods</topic><topic>Gastroenterology</topic><topic>Gastroesophageal reflux</topic><topic>Gastroesophageal Reflux - etiology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Lung Transplantation</topic><topic>Lung transplants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Review</topic><topic>Review Article</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krahelski, Oliver</creatorcontrib><creatorcontrib>Ali, Iihan</creatorcontrib><creatorcontrib>Namgoong, Christopher</creatorcontrib><creatorcontrib>Dave, Kavita</creatorcontrib><creatorcontrib>Reed, Anna</creatorcontrib><creatorcontrib>Ashrafian, Hutan</creatorcontrib><creatorcontrib>Reddy, Marcus</creatorcontrib><creatorcontrib>Khan, Omar</creatorcontrib><creatorcontrib>Das, Bibek</creatorcontrib><creatorcontrib>Fehervari, Matyas</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krahelski, Oliver</au><au>Ali, Iihan</au><au>Namgoong, Christopher</au><au>Dave, Kavita</au><au>Reed, Anna</au><au>Ashrafian, Hutan</au><au>Reddy, Marcus</au><au>Khan, Omar</au><au>Das, Bibek</au><au>Fehervari, Matyas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2025</date><risdate>2025</risdate><volume>39</volume><issue>1</issue><spage>19</spage><epage>38</epage><pages>19-38</pages><issn>0930-2794</issn><issn>1432-2218</issn><eissn>1432-2218</eissn><abstract>Introduction
Gastroesophageal reflux disease (GORD) and aspiration are risk factors in the development of bronchiolitis obliterans syndrome (BOS) in the lung transplant population. The aim of this study was to investigate if allograft function and survival improved after anti-reflux surgery (ARS) in lung transplant recipients.
Methods
In accordance with PRISMA guidelines, we conducted a systematic search of MEDLINE, Embase, and the Cochrane library databases from inception until 13/01/2024. Articles reporting outcomes of ARS following lung transplantation were included. A random effects model was used for meta-analysis.
Results
The search identified 20 which were used for quantitative analysis. Overall, FEV1 and rate of change of FEV1 had improved following ARS by 0.141 L/s (95% CI; −02.82, −0.001) and −1.153 mL/d (95% CI; −12.117, −0.188), respectively. Survival hazard ratio post-ARS was 0.39 (95% CI; 0.19, 0.60). Nissen fundoplication was the most effective anti-reflux procedure with the greatest effect on reduction in the rate of change of FEV1, with an improvement of −2.353 mL/d (95% CI; −3.058, −1.649).
Conclusion
ARS in lung transplant recipients improves allograft function and survival. Given the increased incidence of GORD in lung transplant recipients, there should be a low threshold for investigation of GORD and subsequent ARS.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>39586876</pmid><doi>10.1007/s00464-024-11392-8</doi><tpages>20</tpages><orcidid>https://orcid.org/0000-0002-0796-5150</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Bronchiolitis Obliterans - etiology Fundoplication - methods Gastroenterology Gastroesophageal reflux Gastroesophageal Reflux - etiology Gynecology Hepatology Humans Lung Transplantation Lung transplants Medicine Medicine & Public Health Postoperative Complications - epidemiology Postoperative Complications - etiology Proctology Review Review Article Surgery |
| title | Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis |
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