Procedure: esophagogastroduodenoscopy
EGD will be done pretransplant then again before 18mos post transplant.
Other: Standard GER questionnaire (RDQ)
RDQ questionnaire will be done pretransplant then again before 18mos post transplant.
Procedure: Scintigraphic evaluation of solid gastric emptying
Scintigraphic evaluation of solid gastric emptying will be done pretransplant then again before 18mos post transplant.
Procedure: Twenty-four hour ambulatory pH testing
Twenty-four hour ambulatory pH testing will be done pretransplant then again before 18mos post transplant.
Procedure: Esophageal manometry testing
Esophageal manometry testing will be done pretransplant then again before 18mos post transplant.

Part of standard pre-transplant work up includes a gastrointestinal (GI) work-up to check for GER. The following procedures will be done pre-transplant.

1. Standard GER questionnaire (RDQ): This is a 12 item questionnaire. This questionnaire will ask questions about any reflux symptoms present.
2. Esophagogastroduodenoscopy (EGD): This test will determine evidence of esophageal reflux and presence of a hiatal hernia.
3. Scintigraphic evaluation of solid gastric emptying: This measures the speed with which food empties from the stomach and enters the small intestine.
4. Twenty-four hour ambulatory pH testing: The ambulatory 24-hour pH monitoring test will monitor the acid in the esophagus during a 24-hour period.
5. Esophageal manometry testing: This procedure is done to evaluate the cause of reflux of stomach acid and contents back into the esophagus, and to determine the cause of problems with swallowing food.

These procedures will be done again at 3 to 6 months post transplant. The results of the EGD, scintigraphic evaluation, answers of RDQ, pH testing, esophageal manometry and bronchoscopy will be collected as well as spirometries and any episodes of rejection.