Universität zu Köln

Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Patil, Nikhil P., Mohite, Prashant N., Saez, Diana Garcia, Zych, Bartlomiej, Popov, Aron-Frederik ORCID: 0000-0003-4226-3004, Weymann, Alexander, Wahlers, Thorsten, De Robertis, Fabio, Bahrami, Toufan, Amrani, Mohamed and Simon, Andre R. (2014). Influence of Donor Smoking on Midterm Outcomes After Lung Transplantation. Ann. Thorac. Surg., 97 (3). S. 1015 - 1022. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1552-6259

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Abstract

Background. Lung transplantation (LTx) is significantly limited by donor organ shortage. Donor smoking history of more than 20 pack-years is considered an extended donor criterion. In this study, we retrospectively evaluated impact of donor smoking history and extent of smoking on midterm outcome after LTx. Methods. In all, 237 LTx were performed in our institution between 2007 and 2012. Patients were divided into three groups, receiving lungs from 53% nonsmoking donors, 29% smoking donors with fewer than 20 pack-years, and 18% heavy smokers with more than 20 pack-years. Results. Preoperative donor and recipient characteristics among the groups were comparable. However, donors from the heavy smokers group were significantly older (p < 0.001). The overall presence of abnormal histology (inflammation or metaplasia) in donor main bronchi samples increased with the extent of smoking but did not reach statistical significance (p = 0.211). Although metaplasia was found in significantly more donors from the heavy smokers group (p = 0.037), this did not translate into inferior outcomes for the recipients. There were no statistically significant differences in PaO2/FiO(2) ratio after LTx, duration of mechanical ventilation (p = 0.136), intensive care unit stay (p = 0.133), and total postoperative hospital stay (p = 0.322). One-year and three-year survival were comparable across all three groups (log rank p = 0.151). Prevalence of bronchiolitis obliterans syndrome (p = 0.616), as well as bronchiolitis obliterans syndrome free survival (p = 0.898) after LTx were also comparable. Conclusions. In our experience, history and extent of donor smoking do not significantly affect early and midterm outcomes after LTx. Although this finding does not obviate the need for longer-term observation, donor lungs from even heavy smokers may not per se contraindicate LTx and may provide a valuable avenue for expanding donor organ availability. (C) 2014 by The Society of Thoracic Surgeons

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Patil, Nikhil P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohite, Prashant N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Saez, Diana Garcia UNSPECIFIED UNSPECIFIED UNSPECIFIED Zych, Bartlomiej UNSPECIFIED UNSPECIFIED UNSPECIFIED Popov, Aron-Frederik UNSPECIFIED orcid.org/0000-0003-4226-3004 UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED De Robertis, Fabio UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahrami, Toufan UNSPECIFIED UNSPECIFIED UNSPECIFIED Amrani, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Simon, Andre R. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-444800
DOI:	10.1016/j.athoracsur.2013.11.020
Journal or Publication Title:	Ann. Thorac. Surg.
Volume:	97
Number:	3
Page Range:	S. 1015 - 1022
Date:	2014
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1552-6259
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CIGARETTE-SMOKING; CRITERIA; INFLAMMATION; SURVIVAL; HISTORY; IMMUNE; IMPACT; SCORE; POOL Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44480