Pulmonology · Surgery · Gastroenterology · 2 h ago
Lung Transplant Cohort Finds No Clear Outcome Benefit With Proton Pump Inhibitors
A single-center retrospective study of 1,308 lung transplant recipients found no association between proton pump inhibitor use and time to chronic lung allograft dysfunction or death/retransplantation. Use exceeded 90% from 2007 onward, but the observational findings do not establish whether treatment is beneficial or ineffective.
- Cohort included 1,308 one-year survivors without chronic lung allograft dysfunction.
- PPI exposure occurred in 89.4% of recipients.
- No association emerged with CLAD or death/retransplantation timing.
- Observational findings do not establish treatment equivalence or ineffectiveness.
A single-center retrospective cohort study in Clinical Transplantation evaluated proton pump inhibitor (PPI) use in 1,308 adult first-time lung transplant recipients transplanted between 1999 and 2018. All were alive and free of chronic lung allograft dysfunction (CLAD) at one year. Gastroesophageal reflux disease is a recognized risk factor for CLAD, but evidence linking long-term PPI treatment to transplant outcomes is limited. Exposure was defined as at least eight continuous weeks of PPI use during the first year, initiated within six months after transplantation.
Overall, 1,170 recipients (89.4%) received PPIs; use remained above 90% from 2007 onward. Multivariable analyses found similar time to CLAD and time to death or retransplantation among exposed and unexposed recipients. Outcomes also did not differ by once- versus twice-daily dosing or after accounting for reflux episodes measured by 24-hour pH-impedance monitoring. Positive bronchoalveolar lavage cultures and acute rejection during the first year were comparable.
The findings question routine PPI use for improving transplant outcomes, rather than its established role in symptomatic reflux treatment. However, the retrospective, single-center design cannot establish causality, and inclusion only of one-year survivors without CLAD limits applicability to early post-transplant outcomes. The available abstract provides no effect estimates or confidence intervals, limiting assessment of the precision of these null findings.
Is this summary clinically accurate?
Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.
Sign in to rate this summary →Source
Clinical Transplantation: Long‐Term Proton Pump Inhibitors in Lung Transplant Recipients: Near‐Universal Use Without Clear Impact on Clinical Outcomes Over a 20‐Year Observational Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.