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Background: Gastroesophageal reflux disease (GERD) has been associated with bronchiolitis obliterans syndrome (BOS), a form of rejection after lung transplantation. Recent evidence suggests that laparoscopic antireflux surgery (LARS) may control the decline in lung function characteristic of BOS. However, the safety of LARS in lung transplant patients is unknown, as no reports have been published to address this issue objectively. The aim of this study is to determine the safety of LARS in the lung transplant population. Our hypothesis is that LARS is as safe in the lung transplant population as it is in patients who have not undergone lung transplantation.Materials and Methods: We retrospectively compared the outcomes of LARS of 18 consecutive patients who have undergone lung transplantation to those of 21 consecutive patients (control group) with neither lung disease or lung transplantation who had LARS between November 2008 and October 2009. Results: There was no statistically significant difference in complication rates after LARS between the lung transplant population and the control group (p=0.88). The lung transplant population faced significantly higher surgical risk than the control group (mean ASA class: 3 vs. 1.7; p=0.0001). Conversely, patients in the control group had significantly higher prevalence of hiatal hernia and dysplasia than the lung transplant population (p=0.004 and 0.0001, respectively). The average length of stay was similar in both the lung transplant population and the control group (1.7 vs. 1.8 days; p=1.0) regardless of complications. Time since lung transplant had no effect on complication rate (p=0.92). There was no in-hospital or 30-day mortality for any patient.Conclusions: Previous reports indicate acceptable safety of LARS in the lung transplant population, though this has not yet been assessed against a control group. We demonstrated that LARS is equally as safe in lung transplant patients as it is in the general population with GERD. Therefore, LARS is a safe and acceptable procedure to address GERD after lung transplantation.