期刊
JOURNAL OF CLINICAL GASTROENTEROLOGY
卷 34, 期 1, 页码 34-39出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00004836-200201000-00007
关键词
gastroparesis; heart-lung transplantation; prevalence; gastric emptying scintigraphy
资金
- NCRR NIH HHS [RR00349] Funding Source: Medline
- NIDDK NIH HHS [K24 DK02921] Funding Source: Medline
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR000349] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [K24DK002921] Funding Source: NIH RePORTER
Goals: To determine the prevalence, severity, and outcome of gastroparesis after heart and lung transplantation (HLT). Study: Ten patients (five women; age range, 27-57 years) underwent HLT at Temple University Hospital from 1996 to 1999. The chart of these patients were reviewed, including results from gastric emptying scans and upper endoscopies. Symptoms were assessed with a standardized questionnaire. Results: The indications for HLT included pulmonary hypertension in six patients, Eisen-menger syndrome in two, and dilated cardiomyopathy and congenital heart disease in two. Four patients died before the start of this clinical analysis. The six surviving patients constituted our study population. The patients' posttransplantation follow-up period ranged from 1.4 to 4.4 years (average, 2.6 years). Five patients (83%) were symptomatic with nausea, vomiting, and postprandial abdominal distension. Solid phase gastric emptying was delayed in all five patients with mean gastric retention of 93% at 2 hours (normal < 50%). Patients generally did not respond to prokinetic agents. Four patients required pyloroplasty with J tube placement for symptom control, nutrition, and delivery of immunosuppressive medication. Conclusions: There is a high prevalence of symptomatic gastroparesis in patients after HLT. The gastroparesis is severe and often resistant to prokinetic agents.
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