Can a person who was a heavy smoker be a lung donor?

Lungs from carefully selected donors with a heavy smoking history can be used with good results in adult, double-lung transplants, according to a study released at the 49th Annual Meeting of the Society of Thoracic Surgeons. Transplants from heavy smokers composed 13% (766) of the double-lung transplants studied. A heavy smoking history is defined as at least a pack a day for more than 20 years.

The researchers found that patients who received lungs from carefully selected donors with a history of heavy smoking had similar short- and medium-term survival compared with patients who received donor lungs from non-heavy smoking donors. Lung function was not worse when using heavy smoking donors, and the number of deaths due to malignant cancers was not different.

Lung transplantation has been shown to be an effective treatment for end-stage lung disease; however, this treatment is limited by a critical shortage of donor organs. Transplantation guidelines recommend against using lungs from donors with a history of heavy smoking, but this study finds that lungs from a heavy smoker may be accepted by a transplant surgeon in special situations. For example, a surgeon may choose to transplant lungs from a healthy donor who has good lung function despite heavy smoking, or lungs may be accepted from a less than ideal donor for a very sick patient. This may help decrease the shortage of donor lungs and decrease waiting list mortality.

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