Study finds lungs from heavy smokers OK for transplant

Researchers from Temple University in Philadelphia found that lungs from carefully selected donors who smoked at least a pack a day for more than 20 years may be used in certain transplant situations without affecting recipients' survival rates or deaths from lung cancer.

The study authors said the use of lungs donated by heavy smokers could help more patients get the life-saving double-lung transplant they need.

"Our findings demonstrate that the current criteria for lung transplantation can potentially be revised to include donors with a heavy smoking history," Dr. Sharven Taghavi, from Temple University Hospital, said in a news release from the Society of Thoracic Surgeons. "This may help decrease the shortage of donor lungs and decrease waiting list mortality."

"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," Taghavi said.

In conducting the study, the researchers examined data from the United Network for Organ Sharing on 5,900 people who received a double-lung transplant between 2005 and 2011. Of these patients, 13 percent received lungs donated by a heavy smoker.

The study found that patients who received carefully screened lungs from donors who smoked had short- and medium-term survival rates similar to those who got lungs from people who didn't smoke. The researchers added that the lung function of the patients who received lungs from heavy smokers was not worse and there was no difference in deaths from cancer.

The study's authors noted, however, that lungs from heavy smokers must be examined closely to ensure they are free of cancer and other disease.

Dr. Yoshiya Toyoda, also from Temple, said the smoking history of the patients providing the lungs might not always be accurate.

"Lungs from heavy smokers must be carefully evaluated," Toyoda said in the news release. "We recommend a CT scan for evidence of tumors and emphysema in addition to routine assessment including blood gas, bronchoscopy and visual inspection."

Toyoda also said potential recipients of lungs from heavy smokers must be made aware of the possible higher risk of developing lung cancer.

The U.S. National Heart, Lung, and Blood Institute reports that every year only 50 percent of people who need a double-lung transplant will actually get one. Complicating matters, double-lung transplants now outnumber single-lung transplants.

More than 1,600 people were on the Organ Procurement and Transplantation Network waiting list for a lung transplant at the end of 2012, the study authors said.

The study was to be presented Tuesday at the annual meeting of the Society of Thoracic Surgeons in Los Angeles. Research presented at medical meetings is considered preliminary because it hasn't been subjected to the same scrutiny as studies published in peer-reviewed publications.

More information: The U.S. National Institutes of Health has more on lung transplants.

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