S3115 Prevalence and Incidence of Gastroparesis Following Lung or Heart Transplantation: A Systematic Review and Meta-Analysis

Introduction: Gastroparesis (GP) is a recognized complication following solid organ transplantation that may impact nutritional status, medication absorption, and overall outcomes. We aimed to quantify the pooled prevalence and incidence of GP, specifically after lung and heart transplantation. Methods: We systematically searched PubMed, Embase, Medline, Scopus, and Web of Science through January 2025 for studies reporting the prevalence or incidence of GP following lung or heart transplantation. Two independent reviewers screened studies, extracted data, and assessed the risk of bias. Using R statistical software, we conducted random-effects meta-analysis to calculate pooled estimates with 95% confidence intervals (Cis), stratified by transplant type. Heterogeneity was evaluated using Cochran's Q and I2 statistics. We conducted leave-one-out analysis, influence diagnostics, and examined publication bias using funnel plots and Egger’s test. Meta-regression explored the impact of age and sex. Results: Of the 1,255 initially identified studies, 25 studies with a total of 2,982 patients met the inclusion criteria after rigorous screening. Women constituted 1,308 (44.57%) of the total participants. The mean age was 45.8 ± 11.74. The overall prevalence of GP was 31.07% (95% CI 20.71-43.75%; I2 = 95.1%; P < 0.0001). Subgroup analysis revealed a higher prevalence of GP in combined lung and heart transplant recipients (40.22%; 95% CI 18.05-67.27%) compared to lung transplant only (27.29%; 95% CI 16.74-41.19%), though this difference was not statistically significant (P = 0.3711). The overall incidence was 27.18% (95% CI 17.33-39.93%; I2 = 92.2%; P < 0.0001), with combined transplant recipients showing higher incidence (37.18%; 95% CI 23.21-53.69%) than lung transplant only (21.13%; 95% CI 10.59-37.73%; P = 0.1418). Sensitivity analyses through leave-one-out and influential case removal could not fully resolve the considerable heterogeneity. Meta-regression analysis showed no significant association between GP prevalence or incidence and patient age or sex. Egger's regression test indicated no significant publication bias for prevalence (P = 0.6698) or incidence (P = 0.4601) outcomes. Conclusion: This analysis highlighted the high prevalence of GP following lung or heart transplantation, occurring in approximately 31% of patients overall. Thus, standardized GP screening protocols before and after transplantation might be warranted.