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Donated Smokers' Lungs Are Better Than None

Those who need a lung transplant benefit most of all from a smoke-free pair. But smokers' organs can still help.

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Smokers can still be helpful donors.
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By Bryan Le

05/29/12

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Unsurprisingly, the best secondhand lungs you can get are from non-smokers. But new research shows that for those in need, smokers' lungs are still better than no transplant at all. The UK study, published in The Lancet, is an important contribution to policy debate in a country where about 40% of donated lungs come from smokers. And it's highly relevant in the US too. Following some cases of patients dying after receiving smokers' lungs, some critics demanded restrictions on lung donations. But many doctors say this would be a bad idea: demand is already larger than the supply of donated lungs, and restrictions could lead to more patients dying while waiting for a transplant. Although getting a smoker's lungs leaves a patient 46% more likely to die within three years than getting a non-smoker's lungs, it still provides a 21% better survival rate than just sitting and waiting for a pair. Restrictions on lung donations "could deny patients the opportunity to get help," says Dr. James Neuberger, one of the study's authors. No similar studies have been done on lung-transplant patient survival in the US, but the outlook may well be similar, as the US and UK both have smoking rates of around 20%. And with about 1,800 lung transplants carried out annually in the US—typically to patients with diseases like cystic fibrosis, who are otherwise likely to die within one or two years—many of these lungs likely once belonged to smokers.  “There's rarely an 'ideal' organ available,” points out Dr. Norman Edelman, chief medical officer of the American Lung Association. “A smoker donor is really just one more factor to consider.”

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