Lung transplant patients do worse with lungs from heavy drinkers

January 20, 2015, Loyola University Health System

Lung transplant patients who receive lungs from heavy drinkers are nearly nine times more likely to experience a life-threatening complication called primary graft dysfunction, a Loyola University Medical Center study has found.

Lungs transplanted from heavy alcohol users also displayed poorer gas-exchange, and spent more time on ventilators, lead author Erin Lowery, MD, and colleagues report in the journal Alcoholism: Clinical and Experimental Research.

The study also found a trend toward poorer survival among patients who received lungs from .

"Our findings could have implications for recipients of transplantation," Dr. Lowery said. "We need to understand the mechanisms that cause this increased risk so that in the future donor lungs can be treated, perhaps prior to transplant, to improve outcomes."

Previous studies have found that alcohol abuse increases the risk to drinkers of tuberculosis, pneumonia and a severe form of called acute respiratory distress syndrome. The new study is the first to explore the impact of heavy alcohol use in donors.

The study included 173 lung transplants performed at Loyola. Heavy alcohol use was defined as women who drank more than three drinks per day or seven drinks per week and men who drank more than four drinks per day or 14 drinks per week. To be considered heavy alcohol users, donors also had to show either an abnormal liver biopsy or abnormal alcohol biomarkers.

Nearly 25 percent of the lung donors were heavy alcohol users. This is in line with previous studies that found that 23 percent of heart donors and 21 percent of kidney donors were alcohol dependent.

Researchers found that, after controlling for other risk factors, patients who received lungs from heavy alcohol users were 8.7 times more likely to develop severe primary graft dysfunction (PGD) than patients who received lungs from donors who did not drink.

PGD is a severe form of lung injury that can occur during the first three days after transplant. Many patients die from PGD, while survivors can experience worse long-term lung function and an increased chance of chronic rejection.

Researchers also found that during the first 24 hours after transplant, the ratio of oxygen carried in the blood to oxygen given to the patient (a measure of how well lungs perform gas exchange) was significantly worse in patients who received lungs from heavy alcohol users.

In an accompanying commentary in Alcoholism, David Guidot, MD, of Emory University School of Medicine wrote the Loyola study "raises the question as to whether or not a history of heavy alcohol use by a potential donor should exclude the use of their lungs in transplantation. At a time when there is a critical shortage of lungs available for transplantation, this is obviously a problematic issue. If other studies support the dramatically increased risk of primary graft dysfunction that Lowery and her colleagues have identified then the lung transplant professional community must confront this thorny question."

Dr. Guidot added that the Loyola study and other studies on the "alcoholic lung" should serve as a "call to action to develop treatments that can mitigate the effects of on and improve the donor pool."

Explore further: Donor smoking and recipient obesity tied to higher rates of death and lung injury after lung transplantation

More information: The study is titled "Heavy Alcohol Use in Lung Donors Increases the Risk for Primary Graft Dysfunction."

Related Stories

Donor smoking and recipient obesity tied to higher rates of death and lung injury after lung transplantation

March 7, 2013
(Medical Xpress)—A multi-institution study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has identified several important risk factors, including a donor's smoking history and recipient ...

Stem cell therapy may help recondition lungs previously rejected for transplant

July 10, 2014
Nearly 1,650 people in the U.S. are awaiting lung transplants. Unfortunately, both domestically and abroad, the demand for donor lungs far outpaces the supply. The limited availability of donor lungs can lead to long delays ...

Cause of donor death should not automatically exclude lungs from transplant consideration

October 1, 2014
Patients receiving lungs from donors whose cause of death was asphyxiation or drowning have similar outcomes and long-term survival as patients receiving lungs from traditional donors, according to a study in the October2014 ...

Study finds lungs from heavy smokers OK for transplant

January 29, 2013
(HealthDay)—Lungs of heavy smokers can be donated safely for use in adult double-lung transplants, a new study contends.

Shedding new light on double-lung transplants

January 27, 2014
In the largest retrospective study to date using data from the United Network for Organ Sharing (UNOS) database for adult double-lung transplants, Temple University School of Medicine researchers have shown that there is ...

Recommended for you

Clues found to early lung transplant failure

May 21, 2018
Among organ transplant patients, those receiving new lungs face a higher rate of organ failure and death compared with people undergoing heart, kidney and liver transplants. One of the culprits is inflammation that damages ...

In breakthrough, surgeon builds windpipes from arteries

May 20, 2018
Where others failed, sometimes spectacularly, French surgeon Emmanuel Martinod has helped people whose windpipes have been ravaged by cancer and other diseases to live and breathe normally again.

Blood type O patients may have higher risk of death from severe trauma

May 1, 2018
Blood type O is associated with high death rates in severe trauma patients, according to a study published in the open access journal Critical Care that involved 901 Japanese emergency care patients.

Brains, eyes, testes: off-limits for transplants?

April 28, 2018
Since the world's first successful organ transplant in 1954—a kidney—the discipline has advanced to the point where a wounded soldier could have his penis and scrotum replaced in a groundbreaking operation last month.

Emergency treatment by older surgeons linked to slightly lower death rates

April 26, 2018
Patients undergoing emergency surgery who are treated by older surgeons (aged 60 or over) have slightly lower death rates in the first few weeks after their operation than patients treated by younger surgeons (aged less than ...

Bionic suit helps paralyzed patients stand and walk again

April 25, 2018
Patients undergoing physical rehabilitation at Rush for paralyzing injuries are being aided by a robotic suit designed to help raise people to full height and walk.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.