Sisti Joseph D, Bolet Sean Ide, Amanullah Amir, Malik Zubair, Parkman Henry, Maurer Alan, Cheng Ke, Dadparvar Simin
Temple University Hospital Department of Radiology, Division of Nuclear Medicine and Molecular Imaging, Philadelphia, PA USA.
Temple University Hospital Department of Gastroenterology, Philadelphia, PA USA.
Asia Ocean J Nucl Med Biol. 2025;13(1):53-61. doi: 10.22038/aojnmb.2024.80821.1572.
Gastroparesis is a complication following lung transplantation. This study aimed to assess the prevalence of gastroparesis in patients with lung transplants undergoing solid phase gastric emptying scintigraphy (GES). Specifically, we investigated which type of lung transplant is more susceptible to gastroparesis and whether timing of GES post-transplantation impacts diagnosis of severe gastroparesis.
This retrospective analysis included lung-transplant recipients between January 2008 and February 2024, who underwent GES. Patients received a standardized egg sandwich labeled with 500 uCi Technetium-99m sulfur colloid. GES results were compared to normal values for percentages retained at 2- and 4-hours post-meal.
Among 485 lung-transplant recipients, 111 (50% male; mean age 63 years) underwent posttransplant GES. Gastroparesis was diagnosed in 23% of lung transplant recipients during the study period. Of those who underwent GES, 67% exhibited delayed gastric emptying, with 38 patients (34%) demonstrating severe retention (>30% at 4 hours). Delayed gastric emptying rates were highest in bilateral lung transplant recipients (73%), followed by left (66%) and right (56%) lung transplant recipients. Timing of GES beyond 6 months or one-year post-transplant did not significantly increase the incidence of delayed gastric emptying (p>0.05). There was no significant difference in proportion of patients with delayed gastric emptying when patients were stratified by gender and age.
Our findings suggest that laterality of lung transplant does not influence risk of delayed gastric emptying. Moreover, early evaluation of gastrointestinal symptoms with GES did not impact the severity or rate of gastroparesis. We recommend routine screening with GES for symptomatic lung transplant recipients, irrespective of transplant timing, to facilitate timely management and reduce post-operative complications associated with gastroparesis.
胃轻瘫是肺移植后的一种并发症。本研究旨在评估接受固相胃排空闪烁扫描（GES）的肺移植患者中胃轻瘫的患病率。具体而言，我们调查了哪种类型的肺移植更容易发生胃轻瘫，以及移植后GES的时间是否会影响严重胃轻瘫的诊断。
这项回顾性分析纳入了2008年1月至2024年2月期间接受GES的肺移植受者。患者接受了标记有500微居里锝-99m硫胶体的标准化鸡蛋三明治。将GES结果与餐后2小时和4小时保留百分比的正常值进行比较。
在485名肺移植受者中，111名（50%为男性；平均年龄63岁）接受了移植后GES。在研究期间，23%的肺移植受者被诊断为胃轻瘫。在接受GES的患者中，67%表现出胃排空延迟，38名患者（34%）表现出严重潴留（4小时时>30%）。双侧肺移植受者的胃排空延迟率最高（73%），其次是左肺（66%）和右肺（56%）移植受者。移植后6个月或1年后进行GES的时间并未显著增加胃排空延迟的发生率（p>0.05）。当按性别和年龄对患者进行分层时，胃排空延迟患者的比例没有显著差异。
我们的研究结果表明，肺移植的侧别不影响胃排空延迟的风险。此外，用GES对胃肠道症状进行早期评估不会影响胃轻瘫的严重程度或发生率。我们建议对有症状的肺移植受者进行常规GES筛查，无论移植时间如何，以便及时管理并减少与胃轻瘫相关的术后并发症。
