The surgical management of severe gastroparesis in heart/lung transplant recipients

This article describes the use of gastric bypass surgery for severe gastrop aresis in two lung transplant recipients. In addition to feeding intoleranc e, both our patients suffered from severe erosive esophagitis, transfusion- dependent upper GI hemorrhage, and recurrent aspiration pneumonia. They res ponded poorly to promotility agents and were eventually treated with Roux-e n-Y esophagojejunostomy-one patient with subtotal gastrectomy, and one with gastric bypass without distal gastric resection. Both cases were improved by surgery. Early surgical referral may be indicated in the management of l ung transplant recipients with severe symptomatic gastroparesis in whom med ical management has failed. On the basis of our experience, gastric bypass with esophagojejunostomy is a worth while option in lung transplant recipie nts with severe gastroparesis.