Percutaneous endoscopic gastrostomy in comprehensive preparing the patients with severe body mass defciency for lung transplantation

Abstract

Introduction. Currently, lung transplantation is an approved method for treating a wide range of end-stage lung diseases refractory to medical or surgical treatments when patient's life expectancy without transplantation makes no more than two years.The aim was to evaluate the efficacy of continuous nutritional support via percutaneous endoscopic gastrostomy in potential recipients of lung transplantation with a Body Mass Index under 16 kg/m2.Material and methods. The study was based on the analysis of 93 potential recipients with various lung diseases; 27 of them with diagnosed cystic fibrosis. The enteral nutrition results of the patients with cystic fibrosis whose Body Mass Index (BMI) was under 16 kg/m2 were assessed by the increment in BMI and compared between those (15) fed via gastrosomy and those (22) fed per os.Results. As a result of enteral nutrition via the gastrostomy in the daytime and at night, the majority of recipients (73.3% of cases) had the Body Mass Index (BMI) corrected from 0.1 to 4.91 kg/m2 during the first year, the mean BMI increment made 1.87 ± 0.4 kg/m2. After the BMI correction, 11 of the 15 potential recipients were included in the waiting list, and 6 of them (40%) underwent lung transplantation. In the comparison group, the BMI increment was 0.9 ± 0.3 kg/m2, also having reached a significant difference compared to the baseline (p = 0.04). However, the BMI increment in the main group was significantly higher than in the comparison group (p = 0.02).Conclusion. A statistically significant increase in BMI in a group of patients with cystic fibrosis and BMI under 16 kg/m2, has been demonstrated after percutaneous endoscopic gastrostomy, which allows extending the criteria for the inclusion in the waiting list for lung transplantation.