Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2015; 21(30): 9111-9117
Published online Aug 14, 2015. doi: 10.3748/wjg.v21.i30.9111
Published online Aug 14, 2015. doi: 10.3748/wjg.v21.i30.9111
Pre-lung transplant measures of reflux on impedance are superior to pH testing alone in predicting early allograft injury
Wai-Kit Lo, Robert Burakoff, Natan Feldman, Walter W Chan, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, MA 02115, United States
Wai-Kit Lo, Department of Gastroenterology, VA Boston Healthcare System, Boston, MA 02130, United States
Wai-Kit Lo, Robert Burakoff, Hilary J Goldberg, Walter W Chan, Harvard Medical School, Boston, MA 02115, United States
Hilary J Goldberg, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
Author contributions: Chan WW and Lo WK initiated the study concepts and design; Lo WK, Feldman N and Goldberg HJ contributed to data acquisition; Chan WW, Lo WK, Goldberg HJ and Burakoff R analyzed and interpreted the data; Chan WW and Lo WK drafted the manuscript; Chan WW, Lo WK, Goldberg HJ and Burakoff R contributed to the critical revision of the manuscript for important intellectual content; Chan WW and Lo WK performed the statistical analyses; Chan WW provided administrative support and overall study supervision.
Institutional review board statement: The study was approved by the Partners Healthcare Institutional Review Board prior to inception.
Informed consent statement: Informed consent was waived with permission of the IRB board because of retrospective nature of the study, and the low risk to participants.
Conflict-of-interest statement: The authors report no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Walter W Chan, MD, MPH, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States. wwchan@partners.org
Telephone: +1-617-5250338 Fax: +1-617-7326389
Received: February 10, 2015
Peer-review started: February 10, 2015
First decision: April 13, 2015
Revised: April 15, 2015
Accepted: June 9, 2015
Article in press: June 10, 2015
Published online: August 14, 2015
Peer-review started: February 10, 2015
First decision: April 13, 2015
Revised: April 15, 2015
Accepted: June 9, 2015
Article in press: June 10, 2015
Published online: August 14, 2015
Core Tip
Core tip: Gastroesophageal reflux has been associated with poor lung transplant outcomes, including allograft injury and rejection. While ambulatory pH-testing only measures acid reflux, multichannel intraluminal impedance (MII) assesses total bolus reflux, regardless of acidity. Comparison of pH-testing and MII measures of reflux in the prediction of lung transplant outcomes may improve and standardize pre-transplant reflux testing. Our study demonstrated that pre-transplant MII measures of bolus reflux perform better than their pH-testing counterparts to predict early allograft injury post-lung transplantation. MII should be performed alongside pH testing for reflux assessment during pre-lung transplant evaluation.