The Particulars: The general consensus among experts is that lung transplantation using donor organs from those who smoked heavily may worsen prognosis. However, a shortage of donors has sparked efforts to expand the donor pool, and using heavily smoking donors (HSDs; >20 pack years) may alleviate some of the burden. It is unknown if double lung transplantation (DLT) can be safely performed in adults using lungs from HSDs.
Data Breakdown: For a study, DLT recipients with HSDs were compared with patients who did not receive these organs from heavy smokers. Recipients with HSDs were hospitalized for 2.5 days longer than the control group. However, researchers observed similarities in both groups in freedom from bronchiolitis obliterans syndrome, decrement in post-transplant forced expiratory volume in 1 second (FEV1), peak post-transplant FEV1, median survival, and malignancy-related mortality.
Take Home Pearl: Using donor lungs from heavy smokers during double lung transplants appears to be safe, but more research is necessary.