Gastrointestinal Complications in the Postoperative Period of Lung Transplantation: An Integrative Review

Objectives: To investigate the spectrum of gastrointestinal complications (GICs) in patients after lung transplantation (LT), by synthesizing the evidence on prevalence, risk factors, clinical outcomes, and management strategies. Methods: An integrative literature review was conducted by searching the PubMed and Embase databases. Selection criteria included observational studies published in the last 20 years that assessed GICs in adult post-LT patients. Following a structured screening process, 19 articles were selected for the final synthesis. Results: GICs are highly prevalent, with esophageal dysmotility, gastroesophageal reflux, and gastroparesis being the most reported functional conditions. Esophageal dysmotility emerged as an independent risk factor for acute rejection, while gastroparesis was associated with the development of chronic lung allograft dysfunction. Acute surgical complications, such as perforated diverticulitis and intestinal ischemia, had high mortality rates, especially when managed emergently. Conclusion: GICs are frequent events that negatively impact the survival and quality of life of patients undergoing LT. The clinical application of these findings indicates an urgent need for the standardization of screening and early management protocols, with an emphasis on the functional assessment of the esophagus and stomach, to optimize outcomes in this population