EFFECTS OF OROPHARYNGEAL DYSPHAGIA ON LIFE EXPECTANCY IN LUNG TRANSPLANT PATIENTS: A SYSTEMATIC REVIEW

Abstract

In a systematic review we aim to quantify the prevalence of OPD and its impact on life expectancy, pulmonary complications or other long-term outcomes for adult lung transplantation recipients. We conducted a structured search of Pub-med, Embase, Cochrane Library (2000–2025), and relevant Grey literature.; We included studies reporting on OPD incidence, assessment methods, intervention strategies and survival or life-expectancy outcomes of any type. Study design, patient demographics, dysphagia evaluation (video-fluoroscopy, fiberoptic endoscopy), treatments (swallowing therapy, diet modification) and key outcomes were extracted by two reviewers independently; methodological quality was appraised using established risk-of-bias tools. Pooled estimates confirm that diminished swallowing function is associated with an 87% increase in mortality risk (HR 0.13; 95% CI 0.03–0.54) and 2.4-fold higher odds of aspiration pneumonia as well as longer ICU/hospital stays and exclusive one-year mortality among sick swallowers. Although impaired swallowing does not independently foretell chronic lung allograft dysfunction (CLAD)/bronchiolitis obliterans syndrome, its strong association with early morbidity and mortality highlights the need for routine instrumental swallow evaluation in the first month after lung transplantation. Guidelines based on evidence must stress standardization of dysphagia assessment protocols, interdisciplinary attempts to enhance lip muscle strength and fasting by using physical/patient-centered therapies and timely supplements and rehabilitation measures which advanced life quality and overall survival in lung transplants recipients.