ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2020
Bronchoalveolar bile acid and inflammatory markers to identify high-risk lung transplant recipients with reflux and microaspiration.
Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Interventional anti-reflux management for gastro-oesophageal reflux disease in lung transplant recipients: a systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Long-Term Proton Pump Inhibitors in Lung Transplant Recipients: Near-Universal Use Without Clear Impact on Clinical Outcomes Over a 20-Year Observational Study.Clinical transplantation · 2026Observational
- Surveillance Donor-derived Cell-free DNA Allows for the Safe Reduction in Protocol Transbronchial Biopsies After Lung Transplantation.Transplantation direct · 2026Article
- Lung allograft injury improves after gastroesophageal reflux surgery by donor-derived cell-free DNA kinetics.Frontiers in medicine · 2026Article
- Increase in failed swallows from pre- to post-lung transplant esophageal function testing is associated with acute rejection.World journal of transplantation · 2025Article
- Management of microaspiration and gastrointestinal dysfunction after lung transplantation: A narrative review.JHLT open · 2025Review
- The prognostic value of single and repeated ≥10% FEVThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Article
- Chronic Lung Allograft Dysfunction: Clinical Manifestations and Immunologic Mechanisms.Transplantation · 2025Review
- Oesophageal stasis is a risk factor for chronic lung allograft dysfunction and allograft failure in lung transplant recipients.ERJ open research · 2023Article
- Ineffective esophageal motility is associated with acute rejection after lung transplantation independent of gastroesophageal reflux.World journal of gastroenterology · 2023Article
- Shifts in Intestinal Metabolic Profile Among Kidney Transplantation Recipients with Antibody-Mediated Rejection.Therapeutics and clinical risk management · 2023Article
- Integrative metagenomic and metabolomic analyses reveal the role of gut microbiota in antibody-mediated renal allograft rejection.Journal of translational medicine · 2022Article
- Lung Allograft Dysfunction: Does Aspiration Hold the Key?American journal of respiratory and critical care medicine · 2022Article
- Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction.American journal of respiratory and critical care medicine · 2022Article
- Utility of bile acids in large airway bronchial wash versus bronchoalveolar lavage as biomarkers of microaspiration in lung transplant recipients: a retrospective cohort study.Respiratory research · 2022Article
- Investigating Defects of Esophageal Motility in Lung Transplant Recipients.Gastroenterology research · 2022Article
- Fundoplication after lung transplantation in patients with systemic sclerosis-related end-stage lung disease.Journal of scleroderma and related disorders · 2021Article
- Aspiration of conjugated bile acids predicts adverse lung transplant outcomes and correlates with airway lipid and cytokine dysregulation.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2021Article
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Authors and funding
26 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundGastroesophageal reflux disease (GERD) is a risk factor for chronic lung allograft dysfunction. Bile acids-putative markers of gastric microaspiration-and inflammatory proteins in the bronchoalveolar lavage (BAL) have been associated with chronic lung allograft dysfunction, but their relationship with GERD remains unclear. Although GERD is thought to drive chronic microaspiration, the selection of patients for anti-reflux surgery lacks precision. This multicenter study aimed to test the association of BAL bile acids with GERD, lung inflammation, allograft function, and anti-reflux surgery.
methodsWe analyzed BAL obtained during the first post-transplant year from a retrospective cohort of patients with and without GERD, as well as BAL obtained before and after Nissen fundoplication anti-reflux surgery from a separate cohort. Levels of taurocholic acid (TCA), glycocholic acid, and cholic acid were measured using mass spectrometry. Protein markers of inflammation and injury were measured using multiplex assay and enzyme-linked immunosorbent assay.
resultsAt 3 months after transplantation, TCA, IL-1β, IL-12p70, and CCL5 were higher in the BAL of patients with GERD than in that of no-GERD controls. Elevated TCA and glycocholic acid were associated with concurrent acute lung allograft dysfunction and inflammatory proteins. The BAL obtained after anti-reflux surgery contained reduced TCA and inflammatory proteins compared with that obtained before anti-reflux surgery.
conclusionsTargeted monitoring of TCA and selected inflammatory proteins may be useful in lung transplant recipients with suspected reflux and microaspiration to support diagnosis and guide therapy. Patients with elevated biomarker levels may benefit most from anti-reflux surgery to reduce microaspiration and allograft inflammation.
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