Lo WK, Nadella P, Feldman N, Sharma N, Goldberg HJ, Chan WW. Increase in failed swallows from pre- to post-lung transplant esophageal function testing is associated with acute rejection. World J Transplant 2025; 15(4): 107149 [PMID: 41357378 DOI: 10.5500/wjt.v15.i4.107149]
Corresponding Author of This Article
Walter W Chan, MD, AGAF, FACG, Associate Professor, Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States. wwchan@bwh.harvard.edu
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Transplantation
Article-Type of This Article
Retrospective Cohort Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 18, 2025 (publication date) through Mar 25, 2026
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Journal Information of This Article
Publication Name
World Journal of Transplantation
ISSN
2220-3230
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lo WK, Nadella P, Feldman N, Sharma N, Goldberg HJ, Chan WW. Increase in failed swallows from pre- to post-lung transplant esophageal function testing is associated with acute rejection. World J Transplant 2025; 15(4): 107149 [PMID: 41357378 DOI: 10.5500/wjt.v15.i4.107149]
World J Transplant. Dec 18, 2025; 15(4): 107149 Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.107149
Increase in failed swallows from pre- to post-lung transplant esophageal function testing is associated with acute rejection
Wai-Kit Lo, Pranay Nadella, Natan Feldman, Nirmal Sharma, Hilary J Goldberg, Walter W Chan
Wai-Kit Lo, Natan Feldman, Walter W Chan, Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, MA 02115, United States
Pranay Nadella, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States
Nirmal Sharma, Hilary J Goldberg, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA 02115, United States
Author contributions: Chan WW and Lo WK initiated study concepts and design; Chan WW, Lo WK, Feldman N, Sharma N, and Goldberg HJ contributed to acquisition of data; Chan WW, Lo WK, Sharma N, and Goldberg HJ performed analysis and interpretation of data; Chan WW, Lo WK, and Nadella P drafted the manuscript; Chan WW, Lo WK, Nadella P, Feldman N, Sharma N, and Goldberg HJ contributed to critical revision of manuscript for important intellectual content; Chan WW and Lo WK performed statistical analyses; Chan WW provided administrative support and overall study supervision.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Mass General Brigham Institutional Review Board, approval No. 2011P001563.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items
Data sharing statement: Technical appendix, statistical code, and dataset available upon reasonable request and approval by the Institutional Review Board from the corresponding author at wwchan@bwh.harvard.edu.
Corresponding author: Walter W Chan, MD, AGAF, FACG, Associate Professor, Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, United States. wwchan@bwh.harvard.edu
Received: March 17, 2025 Revised: April 14, 2025 Accepted: May 21, 2025 Published online: December 18, 2025 Processing time: 247 Days and 21.8 Hours
Core Tip
Core Tip: Gastroesophageal reflux has been associated with poor outcomes after lung transplantation, though the pathophysiology remains unclear. Lung transplantation itself may modulate this risk through impacts on pulmonary function and intrathoracic pressures, which alters esophageal motility to affect bolus clearance and reflux severity. Our study demonstrated that increased failed swallows from pre- to post-transplant testing was associated with increased risk of acute rejection after lung transplant, and was inversely correlated with baseline percent-predicted total lung capacity. The physiologic impact of lung transplantation may therefore affect esophageal function and contribute to rejection outcomes, suggesting a need for routine manometric testing in this high-risk patient population.
