Donor Smoking History Associated with Increased Risk of Death Following Lung Transplantation, but Lower Risk of Bronchiolitis Obliterans Syndrome.
Cardiothoracic Surgery, University of Iowa, Iowa City, IA
Meeting: 2017 American Transplant Congress
Abstract number: B249
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 May 9, 2025.« Back to 2017 American Transplant Congress