Extent of Donor Smoking and Mid-Term Outcomes after Lung Transplantation – A Single Center Analysis
Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton &
Harefield NHS Foundation Trust, London, Middlesex, United Kingdom
Thoracic and Cardiovascular Surgery, University Hospital Goettingen, Goettingen, Germany
Respiratory and Transplant Medicine, Royal Brompton &
Harefield NHS Foundation Trust, London, Middlesex, United Kingdom
Meeting: 2013 American Transplant Congress
Abstract number: B899
Objective In this study we retrospectively evaluated impact of donor history and extent of smoking on mid-term outcome after LTx.
Methods Between 01.2007 and 09.2012, 237 LTx were performed in our institution (5 patients were excluded due to unknown donor smoking history). Patients were divided in 3 groups receiving lungs from: 123 (53%) non-smoking donors (NS), 68 (29%) smoking donors – <20 pack years (S) and 41 (18%) heavy smokers – >20 pack years (HS). Donor and recipient demographics as well as perioperative data and mid-term outcome were compared.
Results There were no statistically significant differences in: donor cause of death; percentage of: DCD, abnormal CXR and bronchoscopy, Ex Vivo Lung Perfusion (EVLP); donor duration of mechanical ventilation (MV); last pre-retrieval PaO2/FiO2 ratio and total ischemic time. Donors from HS group were significantly older (p<0.001). Preoperative recipient demographics and diagnosis distribution were also comparable. Parameters of early postoperative outcome are presented in Table 1.
| Outcomes after transplantation | NS | S | HS | p value |
| PaO2/FiO2 ratio 24 hours (mmHg) | 348.9±109.6 | 328.3±108.5 | 344.9±105.5 | 0.466 |
| PaO2/FiO2 ratio 48 hours (mmHg) | 351.4±112.4 | 352.8±123.6 | 346.1±95.4 | 0.956 |
| PaO2/FiO2 ratio 72 hours (mmHg) | 348.0±120.4 | 341.4±114.4 | 364.0±109.1 | 0.652 |
| Duration of mechanical ventilation (hours) | 35(14;198) | 50(23;474) | 34(10;96) | 0.136 |
| Intensive care unit stay (days) | 5(3;19) | 11(3;26) | 6(3;19) | 0.133 |
| Hospital stay (days) | 34(21;51) | 33(23;59) | 39(27;56) | 0.322 |
There were no statistically significant differences in prevalence of bronchiolitis obliterans syndrome (p=0.616) as well as BOS free survival (p=0.898). 1 and 3 years survival estimate was also comparable: NS vs. S vs. HS – 77.7% vs. 90.8% vs. 94.9% and 68.7% vs. 82.1% vs. 68.2% (log rang p=0.151).
Conclusions History and extent of donor smoking do not adversely affect LTx mid-term outcome. However, long term observation is necessary.
To cite this abstract in AMA style:
Sabashnikov A, Garcia D, Mohite P, Zych B, Capoccia M, Popov A, Moza A, Robertis FDe, Amrani M, Barahmi T, Carby M, Reed A, Simon A. Extent of Donor Smoking and Mid-Term Outcomes after Lung Transplantation – A Single Center Analysis [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/extent-of-donor-smoking-and-mid-term-outcomes-after-lung-transplantation-a-single-center-analysis/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress