Esophageal Disease and Lung Transplantation: A Difficult Challenge

Lung transplantation is an established therapeutic modality that significantly enhances the quality of life and improves the survival rate of patients with end-stage pulmonary disorders. Despite its effectiveness, lung allografts have one of the shortest survival times among solid organ transplants, and are highly vulnerable to injury, manifesting as acute or chronic rejection. In the context of lung transplantation, chronic rejection has typically referred to as bronchiolitis obliterans (BO) and bronchiolitis obliterans syndrome (BOS). It has been found that early damage to the allograft, such as acute rejection and lymphocytic bronchiolitis, and chronic airway rejection associated with BOS have been associated with gastroesophageal reflux disease (GERD). In view of the robust association between gastroesophageal reflux disease and chronic respiratory illnesses, the high incidence of GERD among recipients of lung transplant and their more rapid advancement to BOS, several investigations have sought to evaluate the effects of GERD diagnosis and management on respiratory outcomes in lung transplant recipients.