ArticleJHLT open2026
Acute impact of lung transplantation on respiratory-swallow coordination, swallowing impairment, and airway invasion: A prospective cohort study.
Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Lung transplant recipients possess premorbid risk factors for swallowing impairment and airway invasion, including potential alterations in respiratory-swallow coordination. Although aspiration is highly prevalent after lung transplantation, the impact of lung transplantation, its procedures, and postoperative pain management on respiration and swallowing are not understood. Methods: A prospective cohort study of adult lung transplant recipients referred for pre- and postoperative modified barium swallow studies. Respiratory signals were synchronously captured with videofluoroscopic images and analyzed to determine the respiratory phase preceding swallowing events. Swallowing impairment and airway invasion were analyzed using the Modified Barium Swallow Impairment Profile and Penetration-Aspiration Scale (PAS). Wilcoxon signed-rank tests, paired Results: Twenty-eight patients were included. Sixty-nine percent of swallows were initiated during expiration before (173/252) and after (166/239) lung transplantation; however, individual variability was noted. Swallowing impairment significantly worsened after lung transplantation, and post-transplant status was associated with greater impairment in 10 physiologic swallowing components and laryngeal penetration/aspiration ( Conclusion: Swallowing impairment and airway invasion worsened after lung transplantation and were associated with atypical respiratory-swallow patterning. These findings suggest acute swallowing complications that warrant early assessment and targeted interventions to mitigate aspiration risk and support short- and long-term postoperative outcomes after lung transplantation.
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