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Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

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  1. Variation in Time to Peak Values for Different Lung Function Parameters After Double Lung Transplantation

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  2. Hyaluronic Acid Is a Biomarker for Allograft Dysfunction and Predicts 1-Year Graft Loss After Liver Transplantation

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  3. First Report of Lung Transplantation in a Patient With Active Pulmonary Mycobacterium simiae Infection

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  4. Rapid decline in glomerular filtration rate during the first weeks following heart transplantation

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  1. One-year mortality increases four-fold in frail patients undergoing cardiac surgery

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  2. Survival in patients with scintigraphic evidence of pulmonary thromboembolism 12 weeks after double lung transplantation

    Research output: Contribution to journalLetterResearchpeer-review

  3. Carotid Stenosis Assessment with Vector Concentration before and after Stenting

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BACKGROUND: The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free of chronic lung allograft dysfunction (CLAD) as morbidity variables.

METHODS: This is a retrospective analysis of 588 consecutive lung transplant recipients and their corresponding 454 donors. Donors were divided into three groups: group 1 included smokers, group 2 nonsmokers, and group 3 had unknown smoking status; these were further divided into three age groups: group A: 0 to 39 years; group B: 40 to 54 years; and group C: ≥55 years.

RESULTS: One hundred fifty-one donors were former or actual smokers, 175 were nonsmokers, and 128 had unknown smoking histories. Baseline forced expiratory volume in 1 second, forced vital capacity, and diffusion capacity of carbon monoxide were lowest in the groups who received lungs from a smoking donor. CLAD-free survival was identical in all smoking groups, and overall survival was better both for lungs from nonsmoking donors and donors with unknown smoking status compared to lungs from smoking donors. One hundred sixty-nine donors were in age group A, 203 in B, and 82 in C. Baseline forced expiratory volume in 1 second, forced vital capacity, and diffusion capacity of carbon monoxide were lowest in the groups who received lungs from donors older than 55 years. Overall survival as well as CLAD-free survival was significantly lower with donors ≥55 years.

CONCLUSIONS: Donor smoking history and older donor age impact lung function, mortality, and CLAD-free survival after transplantation. Because of a shortage of organs, extended donor criteria may be considered while taking waiting list mortality into account.

Original languageEnglish
JournalTransplantation Proceedings
Volume49
Issue number9
Pages (from-to)2161-2168
Number of pages8
ISSN0041-1345
DOIs
Publication statusPublished - Nov 2017

    Research areas

  • Journal Article

ID: 52781067