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Bronchiolitis Obliterans Syndrome in Lung Transplantation pp 219–235Cite as

Gastroesophageal Reflux and Aspiration in Chronic Lung Allograft Dysfunction and Bronchiolitis Obliterans Syndrome: Detection and Treatment

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Part of the book series: Respiratory Medicine ((RM,volume 8))

Abstract

The role of gastroesophageal reflux (GER) as a risk factor in chronic lung allograft dysfunction (CLAD) and/or bronchiolitis obliterans syndrome (BOS) is strongly supported by the cumulative evidence collected to date. Proximal gastrointestinal tract motility studies and pH/impedance testing can be used to diagnose motility abnormalities and GER and to determine whether reflux is acid or nonacid. However, a true gold standard methodology for detecting penetrance of refluxed duodeno-gastric secretions into the lung is lacking, and a definitive marker of GER combined with microaspiration that identifies patients at significant risk for associated allograft injury and dysfunction needs to be determined. Prospective, multicenter, adequately powered clinical trials should be performed to better understand the role of GER in CLAD and to identify appropriate criteria for patient selection for possible surgical correction of GER.

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Authors and Affiliations

  1. Department of Surgery, New York-Presbyterian Hospital, Columbia University Medical Centre, 622 West 168th Street, PH14-108, New York, NY, 10032, USA

    Frank D’Ovidio M.D., Ph.D.

  2. Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo 71, Modena, 41100, Italy

    Beatrice Aramini M.D., Ph.D.

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  1. Frank D’Ovidio M.D., Ph.D.
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  2. Beatrice Aramini M.D., Ph.D.
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Correspondence to Frank D’Ovidio M.D., Ph.D. .

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Editors and Affiliations

  1. School of Medicine & Public Health, Dept. Internal Medicine, Sect. Allergy, University of Wisconsin, Highland Avenue 600, Madison, 53792-9988, Wisconsin, USA

    Keith C. Meyer

  2. Lung Transplant Unit, St. Vincent's Hospital, Victoria Street, Darlinghurst, Sydney, 2010, New South Wales, Australia

    Allan R. Glanville

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D’Ovidio, F., Aramini, B. (2013). Gastroesophageal Reflux and Aspiration in Chronic Lung Allograft Dysfunction and Bronchiolitis Obliterans Syndrome: Detection and Treatment. In: Meyer, K., Glanville, A. (eds) Bronchiolitis Obliterans Syndrome in Lung Transplantation. Respiratory Medicine, vol 8. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7636-8_12

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