Gastroesophageal reflux as a reversible cause of allograft dysfunction after lung transplantation

Gastroesophageal reflux (GER) is increasingly recognized as contributing to a number of pulmonary disorders. The relationship of GER to pulmonary allo graft dysfunction after lung transplantation is unknown. In this report, we describe a lung transplant recipient who developed an acute decline in pul monary function several months after a retransplantation for chronic reject ion. A pulmonary workup at that time, including bronchoscopy with biopsy, r evealed bronchial inflammation with no allograft rejection or infection. Be cause of increasing GI symptoms after retransplantation, the patient also u nderwent additional testing, which revealed severe acid reflux, The treatme nt of this patient's acid reflux with Nissen fundoplication surgery resulte d in a prompt and sustained improvement in his pulmonary function. We sugge st that GER should be; considered among the potential causes of allograft d ysfunction after lung transplantation.