{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T07:15:43Z","timestamp":1776323743233,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,24]],"date-time":"2024-03-24T00:00:00Z","timestamp":1711238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>For many patients with lung disease the only proven intervention to improve survival and quality of life is lung transplantation (LTx). Esophageal dysmotility and gastroesophageal reflux (GER) are common in patients with respiratory disease, and often associate with worse prognosis following LTx. Which, if any patients, should be excluded from LTx based on esophageal concerns remains unclear. Our aim was to understand the effect of LTx on esophageal motility diagnosis and examine how this and the other physiological and mechanical factors relate to GER and clearance of boluses swallowed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively recruited 62 patients with restrictive (RLD) and obstructive (OLD) lung disease (aged 33\u201375\u2009years; 42 men) who underwent high resolution impedance manometry and 24\u2010h pH\u2010impedance before and after LTx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>RLD patients with normal motility were more likely to remain normal (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), or if having abnormal motility to change to normal (<jats:italic>p<\/jats:italic>\u2009=\u20090.07) post\u2010LTx than OLD patients. Esophageal length (EL) was greater in OLD than RLD patients' pre\u2010LTx (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), reducing only in OLD patients' post\u2010LTx (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Reduced EL post\u2010LTx associated with greater contractile reserve (<jats:italic>r<\/jats:italic>\u2009=\u20090.735; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and increased likelihood of motility normalization (<jats:italic>p<\/jats:italic>\u2009=\u20090.10). Clearance of reflux improved (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) and associated with increased mean nocturnal baseline impedance (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in RLD but not OLD. Peristaltic breaks and thoraco\u2010abdominal pressure gradient impact both esophageal clearance of reflux and boluses swallowed (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>RLD patients are more likely to show improvement in esophageal motility than OLD patients post\u2010LTx. However, the effect on GER is more difficult to predict and requires other GI, anatomical and pulmonary factors to be taken into consideration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14788","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T05:50:01Z","timestamp":1711345801000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of lung transplantation on esophageal motility and inter\u2010relationships with reflux and lung mechanics in patients with restrictive and obstructive respiratory disease"],"prefix":"10.1111","volume":"36","author":[{"given":"Ali","family":"Alghubari","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Surgical Sciences, Leeds Institute of Medical Research University of Leeds  Leeds 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R.","family":"DeVault","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-0229","authenticated-orcid":false,"given":"Lesley A.","family":"Houghton","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Surgical Sciences, Leeds Institute of Medical Research University of Leeds  Leeds UK"},{"name":"Department of Gastroenterology and Hepatology Mayo Clinic  Jacksonville Florida 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