Enhancing Lung Transplant Outcomes: The Critical Role of Pretransplant Gastroenterological Evaluations.

OBJECTIVE

This study evaluates the influence of gastroenterological health on lung transplant candidacy and outcomes, advocating for a standardized pretransplant gastrointestinal assessment protocol.

METHODS

A retrospective cohort study was conducted at a high-volume tertiary care center from January 2019 to December 2022. Adult patients undergoing comprehensive pre-transplant evaluations, including detailed gastroenterological assessments, were categorized based on their approval status for lung transplantation.

RESULTS

Among the candidates evaluated, 19.2% were approved for transplantation. Gastroenterological issues led to the rejection of numerous candidates. Significant rejection factors included advanced liver fibrosis (22.6%), Hepatitis B and C, high-grade dysplasia, intra-mucosal carcinoma, and severe cases of gastroesophageal reflux disease (GERD). These conditions, often associated with severe complications such as portal hypertension and cirrhosis, were pivotal in influencing transplant eligibility and patient outcomes.

CONCLUSION

The findings underscore the critical role of gastroenterological health in the lung transplant evaluation process. Implementing a standardized gastrointestinal assessment protocol could enhance the identification of at-risk patients, reduce post-transplant complications, and improve overall outcomes. This study highlights the need for rigorous pre-transplant evaluations to optimize patient management and transplantation success, promoting the integration of comprehensive gastroenterological assessments into standard care practices for lung transplant candidates.