Our Summary

This research looked at whether the health of lung transplant donors, specifically related to smoking or substance use, affected how well the donated lungs worked after transplant and how long the recipients survived. The study looked at over 1300 lung transplants performed at Cleveland Clinic between 2007 and 2020.

The researchers found that almost half of the recipients received lungs from donors who were smokers, and about half received lungs from donors with a history of substance use. They found that whether or not the donor smoked or used substances did not affect the initial success of the transplant. Additionally, the lung function a year after transplant was only slightly worse in recipients who received lungs from smoking donors, and this was only noticeable in patients who received two lungs, not just one. Donor substance use had no effect on lung function.

The study also looked at how long recipients survived after the transplant. They found that recipients who received lungs from smoking donors had a slightly lower survival rate after 5 years. However, whether the donor used substances had no effect on survival.

Overall, the study suggests that lungs from donors who smoke or use substances can be safely used for transplants, especially given the shortage of available organs. These factors alone should not be a reason to rule out potential donors.

FAQs

  1. Did the health of lung transplant donors, specifically related to smoking or substance use, affect the success of the transplant and the survival of the recipients?
  2. What were the findings of the study in relation to the lung function of recipients who received lungs from donors who smoked or used substances?
  3. Should lungs from donors who smoke or use substances be ruled out for transplants based on the study’s findings?

Doctor’s Tip

However, it is still important for lung transplant recipients to maintain a healthy lifestyle after the transplant, including avoiding smoking and substance use themselves. Following a proper post-transplant care plan, including regular check-ups and medication adherence, can help ensure the best possible outcomes after a lung transplant. It is important for patients to discuss any concerns or questions they may have with their healthcare team to ensure they are receiving the best care possible.

Suitable For

Patients who are typically recommended for a lung transplant include those with end-stage lung disease, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, or pulmonary hypertension. These patients often have severe difficulty breathing and reduced quality of life despite medical treatment, and a lung transplant may be their only option for improved survival and quality of life. Additionally, patients must meet certain medical criteria and be healthy enough to undergo the transplant surgery and post-operative care.

Timeline

Before lung transplant:

  1. Patient is evaluated by a transplant team to determine if they are a candidate for a lung transplant.
  2. Patient undergoes medical tests and evaluations to assess their overall health and suitability for a transplant.
  3. Patient is placed on a waiting list for a donor lung based on the severity of their condition and availability of suitable organs.
  4. Patient waits for a suitable donor match to become available.

After lung transplant:

  1. Patient undergoes surgery to receive the new lung(s).
  2. Patient is closely monitored in the hospital for complications and to ensure the new lung is functioning properly.
  3. Patient undergoes rehabilitation and physical therapy to regain lung function and strength.
  4. Patient is discharged from the hospital and continues regular follow-up appointments with their transplant team.
  5. Patient must take immunosuppressant medications for the rest of their life to prevent rejection of the new lung.
  6. Patient must make lifestyle changes, such as quitting smoking and maintaining a healthy diet and exercise routine, to support the new lung.
  7. Patient may experience complications or rejection episodes that require medical intervention.
  8. Patient continues to be monitored and receive care from their transplant team for the rest of their life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung transplant include:

  1. What criteria do you use to evaluate potential lung donors, including their history of smoking and substance use?
  2. How will the health of the donor’s lungs, including any history of smoking or substance use, affect the success of the transplant and my long-term survival?
  3. Are there any specific risks or complications associated with receiving lungs from a donor who smoked or used substances?
  4. How will you monitor and manage any potential issues related to the donor’s smoking or substance use post-transplant?
  5. Are there any steps I can take to improve my outcomes if I receive lungs from a donor with a history of smoking or substance use?
  6. How will you ensure that I receive the best possible care and support throughout the transplant process, regardless of the donor’s health history?
  7. What is the overall success rate of lung transplants from donors who smoke or use substances compared to those who do not?
  8. Are there any alternative options or considerations I should be aware of if I have concerns about receiving lungs from a donor with a history of smoking or substance use?

Reference

Authors: Rappaport JM, Siddiqui HU, Thuita L, Budev M, McCurry KR, Blackstone EH, Ahmad U; Cleveland Clinic Lung Transplantation Center. Journal: J Thorac Cardiovasc Surg. 2023 Aug;166(2):383-393.e13. doi: 10.1016/j.jtcvs.2023.01.028. Epub 2023 Feb 7. PMID: 36967372