Safety and efficacy of an implantable device for management of gastroesophageal reflux in lung transplant recipients

Journal of Thoracic Disease

article

Samantha E. Halpern¹  Aryaman Gupta²  Oliver K. Jawitz²  Ashley Y. Choi¹  Hai V. Salfity²  Jacob A. Klapper²  Matthew G. Hartwig² 

[1] School of Medicine, Duke University;Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center;School of Medicine, Johns Hopkins University

关键词: Gastroesophageal reflux disease (GERD);    lung transplantation (LTx);    LINX Reflux Management System;   

DOI  :  10.21037/jtd-20-3276

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Magnetic sphincter augmentation (MSA) is a promising minimally invasive surgical technique for management of gastroesophageal reflux disease (GERD); however, device implantation after transplantation has not been studied and may be concerning in these immunosuppressed patients. We explored the safety of the LINX Reflux Management System (MSA device) for management of GERD following lung transplantation (LTx). Methods: Lung transplant recipients who underwent LINX implantation at our institution between 2017 and 2019 were followed prospectively in the Reflux Following Lung Transplantation and Associated Treatment Registry. Ambulatory pH testing and acid-suppressing medication use were compared before and after LINX implantation. One-year outcomes and change in pulmonary function were compared between matched LINX and fundoplication groups. Results: Of 17 patients who underwent post-lung transplant LINX implantation, 8 (47.1%) agreed to undergo post-LINX pH testing. Three/eight (37.5%) patients achieved normal esophageal acid exposure time; 14 (82.4%) remained on acid-suppressing medication at one-year under the direction of their transplant teams. One-year patient survival and change in pulmonary function were similar between groups. LINX patients experienced more early side effects. Conclusions: Use of the LINX MSA device in a cohort of lung transplant recipients at our institution was associated with similar short-term safety compared to traditional fundoplication, however assessment of efficacy was limited. Further investigation is needed to characterize the long-term efficacy of LINX implantation after LTx.

【 授权许可】

Unknown