Lung Transplant and Swallowing: Understanding Postoperative Dysphagia Risk

Lung disease impacts 26 million people in the United States each year, with data in 2024 revealing 3,026 lung transplants completed in 2023 (Heron, 2019; National Data, 2024). Complications following lung transplant often result from damage to the neuroanatomic pathways which can result in altered motor programming, coordination, sensation, and airway protection (Black et al., 2019; Duarte et al., 2012).

Research demonstrates a high occurrence of oropharyngeal dysphagia with silent aspiration after lung transplant, demonstrating the need and benefit of pre- and post-operative instrumental swallowing evaluations (Barilka et al., 2025). Additionally, Graham et al. (2025) found that swallowing impairment and airway invasion increased after lung transplant and were associated with atypical respiratory-swallow patterning. It should be noted that patients may have varying presentations following lung transplant which can be due to the underlying reason for transplant, in which dysphagia may have already been present at baseline (Smaoui et al., 2024). Risk factors for oropharyngeal dysphagia following lung transplant includes the diagnosis of chronic obstructive lung disease, female sex, cardiopulmonary bypass, duration of intubation, and an increased number of transesophageal echocardiography clips (Barilka et al., 2025; Neelankavil et al., 2024; Smaoui et al., 2024).

Proactive swallowing evaluations can aid in determining the presence of oropharyngeal dysphagia prior to lung transplant and identify those at risk for new onset of oropharyngeal dysphagia post operatively (Atkins et al., 2007; Barilka et al., 2025).