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Transplantation |

Prevalence of Gastroparesis in Lung Transplant Recipients Receiving Domperidone: A Single Center Cohort Study

Henriette Heinrich, MD; Macé Schuurmans, MD
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Zurich University Hospital, Gastroenterology and Hepatology, Zurich, Switzerland


Chest. 2013;144(4_MeetingAbstracts):1013A. doi:10.1378/chest.1704635
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Abstract

SESSION TITLE: Lung Transplantation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Lung transplantation (LT) is performed in selected patients with non-malignant end-stage lung diseases. Gastrointestinal complications impact considerably on allograft and patient survival. Gastroparesis (GP) is a recognized complication of LT and contributes to reflux and aspiration. We routinely use domperidone (three times daily) to reduce GP and its consequences. The objective of this study was to assess the prevalence of radiological evidence GP on abdominal plain films (APF) obtained for unclear abdominal symptoms in lung transplant recipients (LTRs).

METHODS: Retrospective chart review with assessment of APF of all LTRs followed up January-March 2013. Number of APF were documented and radiological evidence of GP was documented. Descriptive statistics of patient characteristics with and without GP including level of bronchiolitis obliterans syndrome (BOS).

RESULTS: Of 204 LTRs in our cohort 34 (17%) had clear-cut radiological evidence for GP despite domperidone treatment (GP group). Mean age of GP group was 46 years and 50 years for LTRs without GP (non-PG group). Female to male ratio was 21:13 for the GP group. Diabetes mellitus was diagnosed and treated in 50% of GP and 23% of non-GP group. 19/34 patients had cystic fibrosis as underlying diagnosis. Final BOS and intestinal perforation analysis is pending. Median number of APF per patient was 6 during follow up.

CONCLUSIONS: Gastroparesis can be diagnosed on abdominal plain films in 17% of LTRs despite consequent domperidone treatment. Lung transplant recipients with gastroparesis were predominantly female, diabetic and had an underlying diagnosis of cystic fibrosis.

CLINICAL IMPLICATIONS: Certain domperidone-treated lung transplant recipients for example with diabetes and cystic fibrosis may have to adapt certain life-style and anti-reflux measures to reduce risk of aspiration and reduce symptoms of gastroparesis. Additional medication with prokinetic properties should be considered in these patients.

DISCLOSURE: The following authors have nothing to disclose: Henriette Heinrich, Macé Schuurmans

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