Donor Smoking History Associated with Increased Risk of Death Following Lung Transplantation, but Lower Risk of Bronchiolitis Obliterans Syndrome.

S. Burger, M. Eberlein, J. Keech, E. Arshava, T. Pena, S. Larson, J. Klesney-Tait, K. Parekh.

Cardiothoracic Surgery, University of Iowa, Iowa City, IA

Meeting: 2017 American Transplant Congress

Abstract number: B249

Keywords: Donors, marginal, Outcome, Rejection, Survival

Session Information

Session Name: Poster Session B: Lung Transplantation Poster Session

Session Type: Poster Session

Date: Sunday, April 30, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Purpose: The impact of donor smoking history on long term mortality, causes of mortality and the development of bronchiolitis obliterans syndrome (BOS) following lung transplantation (LTx) is not well defined.

Methods: In a retrospective cohort study of adult LTx-recipients in the SRTR database (10/1987-8/2016) we stratified according to significant donor smoking history (DSH; defined as >20 pack years). We used Cox proportional hazard models and Kaplan Meier survival analysis to examine the effect of DSH on overall survival, conditional on 1 year and 3 year survival, and time dependent impact of donor smoking history on development of BOS after LTx. Logistic regression was used to compare causes of death.

Results: DSH was associated with overall increased risk of death after LTx, and increased risk of death in long-term survival analysis conditional on 1 or 3yr survival, fig1A, table1. When cause of death was examined, the DSH cohort was less likely to die from chronic rejection or pulmonary cause, table1; however, DSH was associated with an increased risk of death from infectious causes. DSH was associated with a trend towards a decreased risk of developing BOS, fig1B. Analysis of time dependent risk showed that DSH was associated with lower risk of BOS in posttransplant years 4-5 and posttransplant years 6-7, table1. Conclusions: The use of heavy smoking donor lungs for transplantation is associated with overall increased risk of death due to all causes after transplant, but a significant decrease in risk of death due to chronic rejection and pulmonary causes, and increased risk of death due to infectious causes. Heavy smoking donor lungs surprisingly have a decreased risk of developing BOS following LTx.

CITATION INFORMATION: Burger S, Eberlein M, Keech J, Arshava E, Pena T, Larson S, Klesney-Tait J, Parekh K. Donor Smoking History Associated with Increased Risk of Death Following Lung Transplantation, but Lower Risk of Bronchiolitis Obliterans Syndrome. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Burger S, Eberlein M, Keech J, Arshava E, Pena T, Larson S, Klesney-Tait J, Parekh K. Donor Smoking History Associated with Increased Risk of Death Following Lung Transplantation, but Lower Risk of Bronchiolitis Obliterans Syndrome. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/donor-smoking-history-associated-with-increased-risk-of-death-following-lung-transplantation-but-lower-risk-of-bronchiolitis-obliterans-syndrome/. Accessed November 22, 2024.

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