{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:46:04Z","timestamp":1790790364019,"version":"4.1.0"},"reference-count":115,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Motility disorders, particularly gastroparesis, are prevalent complications following solid organ transplantation, significantly impacting quality of life, nutritional status, graft survival, and mortality. This comprehensive review synthesises evidence from PubMed, Scopus, and Embase databases on pathophysiology, clinical manifestations, diagnosis, management, and prognostic factors across transplant types. Mechanisms include vagal nerve injury (highest in lung transplants, prevalence 40\u201391%), immunosuppressive effects (e.g., tacrolimus accelerates motility; mycophenolate impairs it), surgical trauma, microbiome dysbiosis (reduced Firmicutes\/Bacteroidetes ratio), and metabolic factors like post-transplant diabetes (OR 5.17 in kidney recipients). Pediatric and thoracic recipients face the highest risks, with lung transplant gastroparesis conferring a 2.7-fold increased mortality\/retransplantation hazard (p &lt; 0.05). Diagnosis relies on gastric emptying scintigraphy (gold standard, sensitivity 85\u201395%) and wireless motility capsules (100% sensitivity for delay), while management encompasses prokinetics (60\u201380% response), endoscopic G-POEM (85% success), gastric electrical stimulation (100% quality-of-life improvement in series), and nutritional support. Prognostic factors include younger age (better intervention response), aetiology (anatomical worse than metabolic), and early therapy success. Outcomes vary: lung recipients experience severe impacts on chronic allograft dysfunction (83% oesophageal motility abnormalities correlate with 66\u201367% rejection). Future directions emphasise microbiome therapies, AI predictive models (AUC 0.85), and wearables for continuous monitoring. Multidisciplinary approaches are essential to balance immunosuppression with GI management, addressing ethical dilemmas like drug interactions and access disparities. Ultimately, early screening and personalised interventions can mitigate complications, enhancing long-term transplant success.<\/jats:p>","DOI":"10.3390\/jcm14217581","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"7581","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Gastric Motility Disorders Post Organ Transplantation\u2014A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7979-2834","authenticated-orcid":false,"given":"Hareesha Rishab","family":"Bharadwaj","sequence":"first","affiliation":[{"name":"Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6671-0929","authenticated-orcid":false,"given":"Thai Hau","family":"Koo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, OH 44109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-9039","authenticated-orcid":false,"given":"Dushyant Singh","family":"Dahiya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, University of Kansas School of Medicine, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyal","family":"Dalal","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Central Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhtasim","family":"Fuad","sequence":"additional","affiliation":[{"name":"Royal Oldham Hospital, Northern Care Alliance NHS Foundation Trust, Oldham OL1 2JH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1374-5143","authenticated-orcid":false,"given":"Sammy","family":"Arab","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8061-6237","authenticated-orcid":false,"given":"Karanjot","family":"Chhatwal","sequence":"additional","affiliation":[{"name":"Imperial College School of Medicine, Imperial College London, London SW7 2AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1452-5515","authenticated-orcid":false,"given":"Taha","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Sarn Ln, Bodelwyddan, Rhyl LL18 5UJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1589-3417","authenticated-orcid":false,"given":"Maham","family":"Malik","sequence":"additional","affiliation":[{"name":"Countess of Chester Hospital NHS Foundation Trust, Liverpool Road, Chester CH2 1UL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, MedStar Health Georgetown University Baltimore Program, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariha","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cooper University Hospital, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tofani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1024-5517","authenticated-orcid":false,"given":"Anthony","family":"Infantolino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, NJ 08103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/ajt.15678","article-title":"OPTN\/SRTR 2018 annual data report: Deceased organ donation","volume":"20","author":"Israni","year":"2020","journal-title":"Am. 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