Oropharyngeal dysphagia and laryngeal dysfunction after lung and heart transplantation: A systematic review

Abstract

Purpose: Oropharyngeal dysphagia and laryngeal dysfunction are known to impact on health outcomes of patients with critical illness. The incidence in patients after heart and/or lung transplantation is unknown. This paper investigates the frequency, characteristics and risk factors for these complications following such transplantation.

Method: Eight databases were systematically searched. Inclusion criteria were (a) adults who underwent heart and/or lung transplantation as their primary surgery, (b) new onset of oropharyngeal dysphagia and/or laryngeal dysfunction and dysphonia identified in the acute hospital phase (c) original studies (d) in English.

Results: Two thousand six hundred and sixteen articles were identified. Five met the inclusion criteria. Studies were few and heterogeneous in design and sample size, therefore meta–analysis was not performed. All included studies were of relatively low quality. However, rates of oropharyngeal dysphagia up to 70.5% were reported, with 25% of these patients presenting with vocal cord palsy.

Conclusions: Limited conclusions can be drawn from the available evidence regarding the frequency, characteristics and risk factors for the development of oropharyngeal dysphagia and/or laryngeal dysfunction after heart and/or lung transplantation due to limited evidence and low quality of the included studies. This highlights the need for high quality studies in this population.

Implications for rehabilitation

• Oropharyngeal dysphagia and dysphonia are known to impact on mortality and quality of life

• There is a paucity of literature describing these complications after lung and/or heart transplantation, however the data available indicates high rates of swallowing and voice disorders in this immunosuppressed population

• Early identification and management of oropharyngeal dysphagia and dysphonia is vital to aid rehabilitation and improve mortality and quality of life in patients following lung and/or heart transplantation

Keywords:

• Swallowing
• aspiration
• voice
• heart lung transplantation

Acknowledgements

The authors wish to acknowledge Katie McKay, previously of Walter McGrath library at St Vincents Hospital, Sydney for her assistance with the electronic search and article retrieval. Special thanks to Katrina Blyth PhD for her reliability and quality ratings.

Disclosure statement

The authors report no declarations of interest