Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation R.Duane Davis,

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Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation R.Duane Davis, MDa, Christine L. Lau, MDa, Steve Eubanks, MDa, Robert H. Messier, MD, PhDa, Denis Hadjiliadis, MDb, Mark P. Steele, MDb, Scott M. Palmer, MDb The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 3, Pages 533-542 (March 2003) DOI: 10.1067/mtc.2003.166 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Average FEV1 values in lung transplant recipients who also underwent fundoplication surgery for treatment of reflux. Patients were at least 6 months from both their lung transplantations and fundoplication procedures to allow stabilization of pulmonary function. A significant improvement in FEV1 was documented in this group after fundoplication. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 533-542DOI: (10.1067/mtc.2003.166) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Effect of GERD on survival: Kaplan-Meier actuarial survival curves for overall lung transplant recipients compared with the group of lung transplant recipients who also underwent fundoplication surgery after being evaluated for GERD. The fundoplication group had a significant survival advantage. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 533-542DOI: (10.1067/mtc.2003.166) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Effect of fundoplication on survival. Kaplan-Meier actuarial survival curves for patients evaluated for reflux by 24-hour pH studies, comparing the group with documented reflux versus the group with no reflux. A significant survival advantage was seen in the patients with normal pH studies. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 533-542DOI: (10.1067/mtc.2003.166) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Kaplan-Meier actuarial allograft survival curves: allograft survival of at least 6 months to adjust for differences between organs on the basis of early technical variables. A, Overall allograft survival (6-month survivors) for patients undergoing kidney, heart, and lung transplantation, documenting a worse outcome in lung transplant recipients. B, Overall allograft survival in lung transplant recipients who did not have reflux or whose reflux was corrected by means of fundoplication compared with recipients of kidney or heart transplants. Allograft survival among the 3 groups was almost identical. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 533-542DOI: (10.1067/mtc.2003.166) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions