Acid reflux surgery could help prevent rejection in lung transplant patients

June 28, 2013, Loyola University Health System

A Loyola University Medical Center study suggests that a procedure to treat acid reflux could help prevent chronic rejection in lung transplant patients.

The study also found that certain proteins found in lung fluid can help predict whether a patient's transplanted lung is more likely to fail.

Results are published in the July, 2013 issue of the Journal of the American College of Surgeons. Authors are P. Marco Fisichella, MD, FACS (first author), Christopher S. Davis, MD, MPH; Erin Lowery, MD, MS; Luis Ramirez, BS; Richard L. Gamelli, MD, FACS and Elizabeth J. Kovacs, PhD.

Lung transplant patients have the worst survivals of all solid . A major reason is bronchiolitis obliterans syndrome (BOS), a condition in which forms around small airways in the lungs. BOS results from of the transplanted lung, and affects about half of lung transplant patients within five years.

Following , patients undergo a procedure every few months to inspect the airways. The procedure, called a , removes fluid from the lung.

Loyola researchers analysed various biomarkers taken from lung fluid during bronchoscopies. Researchers found that, in patients examined 6 to 12 months after transplant, concentrations of certain could predict the likelihood of BOS 30 months after transplant. For example, patients with high concentrations of the biomarker myeloperoxidase and low concentrations of the biomarker ?-1 antitrypsin were more likely to develop BOS.

The study also found that patients who aspirate (inhale fluid into the lungs) show evidence of a more active immune system. In a condition called , gastric contents back up from the stomach into the esophagus and can be inhaled into the lungs. The gastric contents irritate the lungs, triggering the immune system to ramp up and begin rejecting the transplanted lung. As evidence of this, patients who aspirate showed higher levels of neutrophils (a type of immune system white blood cell) and the immune system biomarker interleukin-8 (IL-8).

A minimally invasive procedure called laparoscopic anti-reflux surgery can treat acid reflux. The surgeon reinforces the valve between the esophagus and stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus. The 90-minute procedure requires five small incisions. Patients typically go home the next day, and take about one week to recover, Fisichella said.

Researchers wrote that their findings "justify the surgical prevention of aspiration and argue for the refinement of antirejection regimens."

Explore further: Diabetes key to transplant success, research finds

Related Stories

Diabetes key to transplant success, research finds

June 19, 2013
(Medical Xpress)—Better management of diabetes could dramatically improve outcomes for lung transplant patients, with new research showing that those without diabetes lived twice as long as transplant recipients with the ...

Anti-reflux surgery helps airway function both before and after lung transplant

September 19, 2011
Surgery to correct gastroesophageal reflux disease, or GERD, can preserve lung function in patients with end-stage pulmonary disease both before and after transplantation, according to a new study from the University of Pittsburgh ...

Vitamin D deficiency shown to increase rejection rates in lung transplant patients

April 25, 2012
(Medical Xpress) -- Vitamin D deficiency is associated with an increase in lung transplant rejection and infections, according to research conducted at Loyola University Health System (LUHS). Researchers also found that recipients ...

Study shows antibiotic improves respiratory function in lung transplant patients

May 23, 2012
Researchers in the United Kingdom have determined that azithromycin, a broad-spectrum antibiotic that also has anti-inflammatory properties, can be an effective treatment option for patients suffering from bronchiolitis obliterans ...

Recommended for you

Best of Last Year—The top Medical Xpress articles of 2017

December 20, 2017
It was a good year for medical research as a team at the German center for Neurodegenerative Diseases, Magdeburg, found that dancing can reverse the signs of aging in the brain. Any exercise helps, the team found, but dancing ...

Pickled in 'cognac', Chopin's heart gives up its secrets

November 26, 2017
The heart of Frederic Chopin, among the world's most cherished musical virtuosos, may finally have given up the cause of his untimely death.

Sugar industry withheld evidence of sucrose's health effects nearly 50 years ago

November 21, 2017
A U.S. sugar industry trade group appears to have pulled the plug on a study that was producing animal evidence linking sucrose to disease nearly 50 years ago, researchers argue in a paper publishing on November 21 in the ...

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.