Comparison of swallowing outcomes in single vs. double lung transplant recipients
Swallowing is a physiologically complex, kinematic process that requires highly coordinated activity of numerous nerves and muscles to execute efficient transport of a bolus from the oral cavity to the stomach. Dysphagia, or a difficulty with swallowing, is a concern following lung transplantation due to the high risk of recurrent laryngeal nerve damage, required levels of life-long immunosuppression, and upper airway trauma secondary to prolonged endotracheal intubation (Pomfret, 2016). Post-operatively, repetitive aspiration events can lead to the development of Bronchiolitis Obliterans Syndrome (BOS), a major contributing factor in acute allograft rejection and long-term failure of lung allograft function. The goal of this descriptive, retrospective study is to describe the characteristics of double lung transplant (DLT) swallows through analysis of kinematic swallow durations, airway protection, and physiologic swallow impairments. These results are compared to single lung transplant (SLT) swallow characteristics and two previously published, historical normal cohorts. By explicitly describing the swallow physiology of DLT and SLT recipients, clinically significant risk factors have been identified to assist clinicians and researchers in the development and implementation of better treatment options and safer swallowing strategies post-operatively. These efforts can improve the functional lifespan of the newly transplanted organ and increase patient quality of life.