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The Surgical Management of Severe Gastroparesis in Heart/Lung Transplant Recipients*

Olufemi A. Akindipe, MD; John L. Faul, MD; Mark A. Vierra, MD; George Triadafilopoulos, MD; James Theodore, MD, FCCP
Author and Funding Information

*From the Division of Pulmonary and Critical Care Medicine (Drs. Akindipe, Faul, and Theodore), and the Departments of Surgery (Dr. Vierra) and Gastroenterology (Dr. Triadafilopoulos), Stanford University Medical Center, Stanford, CA.

Correspondence to: James Theodore, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Stanford, CA 94305-5407



Chest. 2000;117(3):907-910. doi:10.1378/chest.117.3.907
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This article describes the use of gastric bypass surgery for severe gastroparesis in two lung transplant recipients. In addition to feeding intolerance, both our patients suffered from severe erosive esophagitis, transfusion-dependent upper GI hemorrhage, and recurrent aspiration pneumonia. They responded poorly to promotility agents and were eventually treated with Roux-en-Y esophagojejunostomy—one patient with subtotal gastrectomy, and one with gastric bypass without distal gastric resection. Both cases were improved by surgery. Early surgical referral may be indicated in the management of lung transplant recipients with severe symptomatic gastroparesis in whom medical management has failed. On the basis of our experience, gastric bypass with esophagojejunostomy is a worthwhile option in lung transplant recipients with severe gastroparesis.

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