Specifically, in accordance with your clinical guidelines, would you please provide information in response to the following questions:-

1. At what point in time/s do you conduct Impedence-pH testing/monitoring after the lung transplant to check for signs of possible reflux disease?

We do not undertake impedance testing in post lung transplant patients. We do undertake oesophageal pH monitoring, and this may be arranged at any time point post lung transplantation

2. Following an impedence test that shows a positive result, how would the hospital respond and would this response be classed routine or urgent?

Not applicable

3. If, further to a positive Impedence-pH test, a bronchoscopy was carried out that showed infection and possible signs of reflux, how would the hospital respond to this and would this response be classed routine or urgent?

Not applicable

4. If, further to questions a-c, an urgent referral to a gastric surgeon was considered to be appropriate as the patient should be considered for laparascopic fudoplication surgery, who would you contact for this?

Upper GI surgical team

5. Is there more than one facility available to you when a laparascopic fundoplication is required ie: a dual source for times when resource/s may be unavailable at one of the facilities?

No – all required surgery is performed at QEHB

6. Typically, how long would you expect this patient to be waiting for a laparascopic fudoplication to be performed following the events outlined in a-e above?

1-3 months