Enhancing Lung Transplant Outcomes: The Critical Role of Pretransplant Gastroenterological Evaluations

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-30 DOI:10.1016/j.transproceed.2025.03.014

Mahmut Yüksel , Erdal Yekeler , Kerem Kenarlı , Diler Taş Kılıç , Fatmanur Çelik Başaran , Yavuz Çağır , Ahmet Akbay , Fatma Ebru Akın , Mevlüt Hamamcı , Çağdaş Kalkan , Hasan Tankut Köseoğlu , Çağdaş Erdoğan

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引用次数: 0

Abstract

Objective

This study evaluates the influence of gastroenterological health on lung transplant candidacy and outcomes, advocating for a standardized pretransplant gastrointestinal assessment protocol.

Methods

A retrospective cohort study was conducted at a high-volume tertiary care center from January 2019 to December 2022. Adult patients undergoing comprehensive pre-transplant evaluations, including detailed gastroenterological assessments, were categorized based on their approval status for lung transplantation.

Results

Among the candidates evaluated, 19.2% were approved for transplantation. Gastroenterological issues led to the rejection of numerous candidates. Significant rejection factors included advanced liver fibrosis (22.6%), Hepatitis B and C, high-grade dysplasia, intra-mucosal carcinoma, and severe cases of gastroesophageal reflux disease (GERD). These conditions, often associated with severe complications such as portal hypertension and cirrhosis, were pivotal in influencing transplant eligibility and patient outcomes.

Conclusion

The findings underscore the critical role of gastroenterological health in the lung transplant evaluation process. Implementing a standardized gastrointestinal assessment protocol could enhance the identification of at-risk patients, reduce post-transplant complications, and improve overall outcomes. This study highlights the need for rigorous pre-transplant evaluations to optimize patient management and transplantation success, promoting the integration of comprehensive gastroenterological assessments into standard care practices for lung transplant candidates.

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提高肺移植预后：移植前胃肠病学评估的关键作用。

目的：本研究评估胃肠健康对肺移植候选人和结果的影响，倡导标准化的移植前胃肠评估方案。方法：于2019年1月至2022年12月在一家大容量三级医疗中心进行回顾性队列研究。接受全面移植前评估的成年患者，包括详细的胃肠病学评估，根据其批准肺移植的状态进行分类。结果：经评估的候选者中，批准移植的占19.2%。胃肠病问题导致许多候选人被拒绝。显著排斥因素包括晚期肝纤维化（22.6%）、乙型和丙型肝炎、高度发育不良、粘膜内癌和严重的胃食管反流病（GERD）。这些情况通常伴有严重的并发症，如门脉高压和肝硬化，是影响移植资格和患者预后的关键因素。结论：研究结果强调了胃肠病学健康在肺移植评估过程中的关键作用。实施标准化的胃肠评估方案可以增强对高危患者的识别，减少移植后并发症，并改善总体结果。这项研究强调了严格的移植前评估的必要性，以优化患者管理和移植成功，促进将综合胃肠病学评估纳入肺移植候选人的标准护理实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.