Smokers' lungs used in half of transplants

Patients given the organs of 20-a-day donors are as likely as others to survive

Almost half of lung transplant patients were given the lungs taken from heavy smokers, with one in five coming from donors who had smoked at least one packet of cigarettes a day for 20 or more years.

Despite this, new research shows that those people given the lungs of smokers were just as likely to be alive up to three years after transplantation as those who had organs from non-smokers. In some cases, they had improved survival rates.

"Donor lungs from even heavy smokers may provide a valuable avenue for increasing donor organ availability," says André Simon, director of heart and lung transplantation and consultant cardiac surgeon at Royal Brompton and Harefield NHS Trust.

"Our findings provide for the first time real world figures for the perceived risk of implantation of lungs from donors with even a heavy smoking history, and they show that such donor lungs may provide a much-needed lease on life to the critically ill patient whose chances of survival diminish with every day or week that passes by on the waiting list.

"I believe that candidates significantly decrease their chances of survival if they choose to decline organs from smokers."

Lung transplantation is a life-saving therapy for patients with end-stage lung disease, but a shortage of organ donors means people are dying while waiting. UK Transplant Registry data show that only 20 per cent get transplants within six months. The figure rises to 51 per cent after three years, but by that time nearly one in three patients has died waiting for a transplant.

The demand for lung transplants, which are carried out for suitable patients with a number of diseases, including chronic obstructive pulmonary disease and cystic fibrosis, far outstrips demand. Using lung transplants from smokers is a way of boosting supply, but such use has attracted concerns and controversy because of a perceived risk to the health of the recipients.

The new research, conducted at Harefield Hospital in north-west London where Professor Sir Magdi Yacoub carried out the first UK heart and lung transplant in 1983, looked for any differences, including short-and medium-term survival, between patients given lungs from smokers and those who had organs from non-smokers.

Over a six-year period since 2007, a total of 237 lung transplants were carried out at Harefield, and 90 per cent were double-lung transplants. Just over half, 53 per cent, had lungs from non-smokers, while 29 per cent were from donors who had smoked for less than 20 years, and 18 per cent had the lungs of people who had smoked 20 or more a day for at least 20 years.

Results show that one-year and three-year survival figures were about the same for all three groups. Those with lungs from non-smokers even fared slightly worse in terms of one-year survival. A total of 77.7 per cent with non-smoking donors' lungs were alive after the first year, compared with 90.8 per cent with smokers' lungs. There were also no differences in a number of other measures, including overall effectiveness of the lungs, the amount of time spent in intensive care, and the length of time in hospital.

The researchers, reporting their findings in the Annals of Thoracic Surgery, say that while there is now considerable research on the ill effects on health of cigarette smoke, including lung cancer, there are differences between individuals. Smoking-related lung injury varies, they say. While some people have excessive lung damage, others carry on functioning despite several years of smoking.

Mr Simon said: "While it may seem strange that these lungs do not perform worse, or recipients of smokers' lungs don't show a higher incidence of lung cancer, it is important to note that one factor in this may be the cessation of smoking – from an organ point of view – at the time of transplantation and that all organs are inspected and assessed at the time of retrieval to ensure maximum quality and safety."

As a result of concerns about the use of smokers' lungs, more patients on transplant waiting lists are being involved in the decision about whether to accept donated organs.

"Possibly, potential recipients now have the option to decline lungs from donors with positive smoking histories, and choose to wait for organs from a non-smoking donor – presumably with fewer risk factors – in the hope of increasing their chances of post-transplantation survival," they say. "However, this choice would be made on the presumption that transplantation will occur before the patient dies on the waiting list or deteriorates to the extent that transplantation is no longer possible. It would also assume that the person's access to transplantation would not be affected by logistic constraints in the future."

Life and Style
ebookNow available in paperback
ebooks
ebookPart of The Independent’s new eBook series The Great Composers
Life and Style
love + sex
Arts and Entertainment
Victoria Wood, Kayvan Novak, Alexa Chung, Chris Moyles
tvReview: No soggy bottoms, but plenty of other baking disasters on The Great Comic Relief Bake Off
Sport
Ashley Young celebrates the winner for Manchester United against Newcastle
footballNewcastle 0 Man United 1: Last minute strike seals precious victory
Life and Style
Tikka Masala has been overtaken by Jalfrezi as the nation's most popular curry
food + drink
Arts and Entertainment
Seth Rogan is one of America’s most famous pot smokers
filmAmy Pascal resigned after her personal emails were leaked following a cyber-attack sparked by the actor's film The Interview
News
Benjamin Netanyahu and his cartoon bomb – the Israeli PM shows his ‘evidence’
people
Arts and Entertainment
80s trailblazer: comedian Tracey Ullman
tv
News
i100
Life and Style
A statue of the Flemish geographer Gerard Kremer, Geradus Mercator (1512 - 1594) which was unveiled at the Geographical Congree at Anvers. He was the first person to use the word atlas to describe a book of maps.
techThe 16th century cartographer created the atlas
Arts and Entertainment
Stephen Tompkinson is back as DCI Banks
tvReview: Episode one of the new series played it safe, but at least this drama has a winning formula
News
i100
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Recruitment Genius: UI / UX Designer

    £25000 - £35000 per annum: Recruitment Genius: This firm are focussed on assis...

    Recruitment Genius: General Processor

    £7 per hour: Recruitment Genius: A vacancy has arisen for a General Processor ...

    Recruitment Genius: Outbound Sales Executive - B2B

    £18000 - £22000 per annum: Recruitment Genius: A great opportunity has arisen ...

    Recruitment Genius: Online Sales and Customer Services Associate

    £14000 - £16000 per annum: Recruitment Genius: Full time and Part time positio...

    Day In a Page

    War with Isis: Iraq's government fights to win back Tikrit from militants - but then what?

    Baghdad fights to win back Tikrit from Isis – but then what?

    Patrick Cockburn reports from Kirkuk on a conflict which sectarianism has made intractable
    Living with Alzheimer's: What is it really like to be diagnosed with early-onset dementia?

    What is it like to live with Alzheimer's?

    Depicting early-onset Alzheimer's, the film 'Still Alice' had a profound effect on Joy Watson, who lives with the illness. She tells Kate Hilpern how she's coped with the diagnosis
    The Internet of Things: Meet the British salesman who gave real-world items a virtual life

    Setting in motion the Internet of Things

    British salesman Kevin Ashton gave real-world items a virtual life
    Election 2015: Latest polling reveals Tories and Labour on course to win the same number of seats - with the SNP holding the balance of power

    Election 2015: A dead heat between Mr Bean and Dick Dastardly!

    Lord Ashcroft reveals latest polling – and which character voters associate with each leader
    Audiences queue up for 'true stories told live' as cult competition The Moth goes global

    Cult competition The Moth goes global

    The non-profit 'slam storytelling' competition was founded in 1997 by the novelist George Dawes Green and has seen Malcolm Gladwell, Salman Rushdie and Molly Ringwald all take their turn at the mic
    Pakistani women come out fighting: A hard-hitting play focuses on female Muslim boxers

    Pakistani women come out fighting

    Hard-hitting new play 'No Guts, No Heart, No Glory' focuses on female Muslim boxers
    Leonora Carrington transcended her stolid background to become an avant garde star

    Surreal deal: Leonora Carrington

    The artist transcended her stolid background to become an avant garde star
    LGBT History Month: Pupils discuss topics from Sappho to same-sex marriage

    Education: LGBT History Month

    Pupils have been discussing topics from Sappho to same-sex marriage
    11 best gel eyeliners

    Go bold this season: 11 best gel eyeliners

    Use an ink pot eyeliner to go bold on the eyes with this season's feline flicked winged liner
    Cricket World Cup 2015: Tournament runs riot to make the event more hit than miss...

    Cricket World Cup runs riot to make the event more hit than miss...

    The tournament has reached its halfway mark and scores of 300 and amazing catches abound. One thing never changes, though – everyone loves beating England
    Katarina Johnson-Thompson: Heptathlete ready to jump at first major title

    Katarina Johnson-Thompson: Ready to jump at first major title

    After her 2014 was ruined by injury, 21-year-old Briton is leading pentathlete going into this week’s European Indoors. Now she intends to turn form into gold
    Syrian conflict is the world's first 'climate change war', say scientists, but it won't be the last one

    Climate change key in Syrian conflict

    And it will trigger more war in future
    How I outwitted the Gestapo

    How I outwitted the Gestapo

    My life as a Jew in wartime Berlin
    The nation's favourite animal revealed

    The nation's favourite animal revealed

    Women like cuddly creatures whilst men like creepy-crawlies
    Is this the way to get young people to vote?

    Getting young people to vote

    From #VOTESELFISH to Bite the Ballot