Dysphagia in Lung Transplant Recipients: Prevalence, Risk Factors and Health-Related Outcomes

A prospective examination of swallow and cough dysfunction after lung transplantation

“…To our knowledge, this is the first prospective study using direct imaging and validated outcomes of swallowing in LT recipients. These prospective data reporting a 40% prevalence of aspiration support our previous retrospective findings in 205 LT recipients where aspiration was observed in 43% of cases 12 . Other retrospective publications have reported prevalence rates ranging from 64% to 75% 13,14,39 .…”

“…A striking observation was that approximately half of the LT recipients who aspirated (47%, n = 36) were silent aspirators (no cough response to aspirate material). 12 These results align with previous work, where findings of oropharyngeal dysphagia were found in over 70% of individuals after LT, 13 and silent aspiration was present in 63% of clinically referred LT recipients who aspirate. 14 Although the prevalence of oropharyngeal dysphagia and tracheal aspiration (sensate or silent) following LT procedures is high and associated with adverse outcomes, 9 underlying mechanisms that contribute to impaired airway protection during swallowing remain poorly understood.…”

“…Although unsafe swallowing was present in only 17% of individuals prior to LT (10% penetration, 7% aspiration), cases of unsafe swallowing increased nearly fivefold, to 84% after LT (39% penetration, 45% aspiration). A striking observation was that approximately half of the LT recipients who aspirated (47%, n = 36) were silent aspirators (no cough response to aspirate material) 12 . These results align with previous work, where findings of oropharyngeal dysphagia were found in over 70% of individuals after LT, 13 and silent aspiration was present in 63% of clinically referred LT recipients who aspirate 14 …”

“…These prospective data reporting a 40% prevalence of aspiration support our previous retrospective findings in 205 LT recipients where aspiration was observed in 43% of cases. 12 Other retrospective publications have reported prevalence rates ranging from 64% to 75%. 13,14,39 Compared to our findings collected in consecutive LT recipients, these earlier reports likely reported higher prevalence rates given that they constituted clinically referred patients with suspected dysfunction and/or because these included subjective clinical swallow evaluations to quantify dysphagia status.…”