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About 13 percent of double-lung transplants in the U.S. came from donors who were heavy smokers, a new study finds.
Using lung transplants from heavy smokers may sound like a cruel joke, but a new study finds that organs taken from people who puffed a pack a day for more than 20 years are likely safe.
What’s more, the analysis of lung transplant data from the U.S. between 2005 and 2011 confirms what transplant experts say they already know: For some patients on a crowded organ waiting list, lungs from smokers are better than none.
“I think people are grateful just to have a shot at getting lungs,” said Dr. Sharven Taghavi, a cardiovascular surgical resident at Temple University Hospital in Philadelphia, who led the new study.
Surprisingly, however, organ recipients who do get smokers’ lungs often learn about it only afterward -- if at all, experts say.
“If someone had a transplant and after the transplant they say, ‘What can you tell me about the donor?' there are a limited number of characteristics we can tell them,” said Dr. Ramsey Hachem, a pulmonologist at Barnes-Jewish Hospital in St. Louis. “We don’t do that routinely before.”
About 13 percent of double-lung transplants in the U.S. came from donors with a heavy smoking history, according to Taghavi’s new study, presented Tuesday at the annual meeting of the Society of Thoracic Surgeons. He and his colleagues analyzed records of some 5,900 adult procedures in the database maintained by the United Network for Organ Sharing, or UNOS, which manages transplants in the U.S.
Typically, that meant smoking at least a pack of cigarettes a day for more than 20 years, or two packs a day for 10 years.
In the end, after all other variables were accounted for, people who got lungs from heavy smokers lived as long and as well as those who got lungs from the tobacco-free, Taghavi found. There was no significant difference in cancers, though the study didn’t specifically look at lung cancer.
“General guidelines say that donors that have smoked should be excluded, but there are certain circumstances in which they can be used,” Taghavi said. “That can be when the donors are otherwise very healthy and there’s no evidence of the really bad effects of smoking, like emphysema.”
Only about 20 percent of smokers actually develop the worst effects of smoking, noted Hachem.
“It is certainly counterintuitive to say we’re going to use lungs from a donor with a smoking history, but the majority of people who smoke do not have lung disease,” said Hachem, who was not involved in the study.
Some people may have smoked for a long time years ago, then stopped, vastly improving the health of the organs. Others could have been active smokers when they died. The data in the study didn’t include that history, Taghavi said.
Freeing up smokers’ lungs could help reduce a shortage that has left more than 1,650 people on the transplant waiting list -- the “last resort” for those with end-stage lung disease, according to the National Heart Lung and Blood Institute. There were nearly 5,200 liver transplants in the U.S. in 2012, but typically only half the people on the list receive lung transplants in a given year, the NHLBI said.
Taghavi emphasized that transplant recipients who get lungs from heavy smokers ought to be told in advance.
“This is a very important point,” he said. “None of this should be done without a thorough discussion with the recipient. They have to be aware that there are risks with accepting these lungs, but there are benefits.”
But Hachem said current practice usually doesn’t include that discussion.
Recipients decide in advance whether to take organs from high-risk donors, including those with a history of infections such as viral hepatitis or HIV. But behavior habits, such as smoking, are almost never disclosed, Hachem said.
“I don’t know what other centers do, but at our center, we don’t get into those details,” he said.
Instead, the organs are inspected carefully and only those found free of disease or disability are approved for transplant. “We’ve sort of screened the organ pretty well,” he said.
Of course, problems can occur. Widespread media reports last year centered on Jennifer Wederell, a 27-year-old British woman with cystic fibrosis who died of lung cancer last year after receiving lungs from a heavy smoker. In 2007, the family of a New Jersey man, Tony Grier, sued the University of Pennsylvania Health System after they said Grier developed lung cancer a month after a 2005 lung transplant. Court records show the case was settled in 2010.
Such cases are very sad -- but also very rare, said Hachem, who noted that all transplants carry inherent risks. And, he said, most transplant recipients are like Randy Cooke, 52, of Chatham, Ill., who received a new set of lungs in 2011.
Cooke, who was diagnosed in 2008 with a degenerative lung disease, said that by the time he was placed on the transplant waiting list, he would have accepted lungs from a heavy smoker -- gladly.
“If I’d have waited another three months, I don’t know if I’d be here talking to you,” he said.
If his lungs had come from a smoker, Cooke trusted that his doctors would have screened out any potential problems.
“You have to take a lot of times what you can get,” he said. “You don’t have a choice. Time is not on your side.”
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This is one reason I find it so hard to side with people on issues. Some were some how down the road some thing comes out that rewrites every thing.
Do the research people. Don't just buy the propaganda and inflated statistics thrown at you by the media. Go to the CDC website and read the actual medical studies done. There is a gene you are either born with or not. If you have the gene, your lung tissue renews itself. People born without the gene have been shown to develop lung cancer without ever smoking. I'm not saying smoking is good for you, and yes, environmental factors do play a role. But your genetic predispositions toward certain ailments are strong. Members of my family have smoked for generations and have lived long, healthy lives. Not one person has ever had cancer. A friend of mine had NINE types of cancer in her family. That is what started me on researching the issue. If you ever took statistics in school, you should know what a joke they are. You can make them say whatever you want. All people that die DO NOT get an autopsy. And the majority of coroners are elected officials, NOT doctors. So to say that statistics culled from death certificates are misleading is an understatement. Everyone has jumped on the environmental bandwagon in this country. There needs to be a LOT more genetic research, and more funding for genetic research if we ever want the real answers.
So true. My immune systems stinks. I'm constantly sick and have passed my poor immune system on to my oldest son. My husband has an awesome immune system and I was hoping our children would inherit it. Oh well, we live with the hand we're dealt with....even if that means my nickname is "Sniffles."
Now maybe people will quit complaining about us smokers. If they do, maybe I will move back to the USA. Currently I cannot tolerate the intolerence.
Stay whereever you are, Alan. We don't want you, nor do we want to pay for your health problems.
Yes, please stay where you are, Alan. Nasty stinky smokers need to go away!
OVUgirl,
See post #11. There should be plenty of sales tax money to cover smokers health problems.
I am not a smoker but I find your comment and generally people like you more offensive than a smoker, And FYI several studies have shown that smokers who develop disease from smoking generally die faster and cost the health care system less money than non smoking people who live longer and require longterm medical care.
Another jerk who thinks that hs opinion is important.
To hear OVU girl and frisbeewerp telling Allan to stay where he is just goes to prove how ignorant people are. Perhaps the guys call you Regina Rottencrotch OVU girl because the odor permeating from between your legs would knock a buzzard off a s*** wagon and perhaps frisbeewerp has come breath from getting down on his boyfriend, but this is America and we all have a right to live life the best we could. I know I smoke but I also don't smoke where it will offend anybody, it is called respect for others, something that either of you know anything about.
Jimmy "knock a buzzard off a s*** wagon"? ROFL that is the funniest thing I have heard in a long time. I'm using that line ASAP. Thanks!
A young woman recently died of lung cancer about 1 year after receiving transplanted smoker lungs. So sad.
So what is your point Nancy, other lung transplant patients die in a month even with lungs that never had cigarette smoke in them.
Your fat body stinks as bad as my cigarette smoke, and your garlic breath is killer but do I worry about secomd hand air? No.
Actually this is now making sense to me. In 1989 my father died during his second bipass operation due to coronary heart disease. They discovered he had had an undiagnosed heart attack in his 30's which had caused a lot of damage to his heart and he had never received treatment or even knew he had had a heart attack until he had another one in his 50's. They should have done a triple bipass the first time and told him he probably would not survive another surgery but 8 years later he had no choice when a blockage in his heart put him back in the hospital and they told us they had new procedures that they could do to fix his heart. Well he didn't survive the operation but I still remember the cardiologist coming out shaking his head and saying he couldn't believe that a man with his history of smoking since he was 9 years old and smoking 3 packs a day, still had the lungs of a non smoker. Granted, the smoking could have caused the heart disease, but he also ate lots of greasy fried foods most of his life too.
Smokers are always going to be "persecuted" and blamed for everything health related. I don't care if people smoke or not. Just don't blow it in my face. What bothers me is that the govt is taking away our rights. That's what I don't like. How about telling the obese folks that go to all you can eat buffets they can no longer go to those establishments if they are overweight? How about telling all the drinkers that pass out at bars that they can't drink anymore? It all boils down to freedom, and last I looked, this is America, Land of the Free. It's all bull@!$%# and I am tired of the government telling us what we can and can't do. So if any of you bitching about smokers ever really thought about this, you would not comdemn them and stand up for them because standing down is only going to take away some of your rights as well. Period.
It's simple. Have the patient / family sign a waiver. Ask a dying person "hey - do you want these lungs from a smoker - or no lungs at all" - and see how many complaints you get.
They should certainly be informed ahead of time, but I don't see too many refusing.
I, take any part from any body that wants to give me what I need to live, But I DRAW THE LINE at a teabaggers brain!
@new reality... now that is funny
It would be hard to transplant a human brain into an animal that did not have a brain to begin with.
It is obvious that you agree with Obama and his liberal minions taking all of our freedoms from us new reality, and it is also obvious that you have a scrotum for a brain.
"There were nearly 5,200 liver transplants in the U.S. in 2012, but typically only half the people on the list receive lung transplants in a given year, the NHLBI said." What does the number of liver transplants have to do with this? It is not shown as a percentage of those awaiting liver transplants, which might be something to include in the article, but the number is completely irrelevant. Of course, liver transplants can come from LIVING donors, whereas lungs cannot. JoNel, the writer of this piece, knows nothing about transplant procedures.
Actually, look up live lung transplants. They are incredibly uncommon, still experimental, but in young people ages 15-30, they have been having success with taking 1 lobe of lung from 3 or 4 donors. It's incredible, but it has worked, and the donors don't suffer any ill consequences...of course, probably not an option if you are a wind instrument player like me, but otherwise : P
Science Daily www sciencedaily com/releases/2011/10/111012113355.htm Smoking Cigarettes Simulates Cystic Fibrosis, which is like having COPD on top of the radiation damaged CFTR gene. Isn't it? Stop lying, stop using people with CF and other diseases to see if they can clear smoke damaged lungs full of bacteria and the addictive nicotine habit. YOU scientists are ghoulish body snatchers. You're worse than in the early 1800's and 1900's grave robbers. YOU have no conscious, you do not help people. YOU ARE the MONSTERS and NAZI's of modern day along with the Pharmacide corporations and GMO synthetic "food" .Why you MOBSTERS get away with this I don't know, but with the monsters GOP, FDA, USDA and others you are criminals. No doubt about that. Criminals. You can't "play" God because GOD does not do these things. MONSTERS is what you are. Stop injecting people with METAL GADOLINIUM for the MAGNETS in the MRI machines, stop the radiation scans and injections. Stop killing people, creating misery. Stop it. Stop it or get out of business.
Most smokers do not die of lung disease. WOW, what a statement by the doctors. Blows the anti-smokers out of the water.
I guess that ends the anti-smoking movement and should bring on REPEALS OF SMOKING BANS EVERYWHERE!
JOINT STATEMENT ON THE RE-ASSESSMENT OF THE TOXICOLOGICAL TESTING OF TOBACCO PRODUCTS"
7 October, the COT meeting on 26 October and the COC meeting on 18
November 2004.
"5. The Committees commented that tobacco smoke was a highly complex chemical mixture and that the causative agents for smoke induced diseases (such as cardiovascular disease, cancer, effects on reproduction and on offspring) was unknown. The mechanisms by which tobacco induced adverse effects were not established. The best information related to tobacco smoke - induced lung cancer, but even in this instance a detailed mechanism was not available. The Committees therefore agreed that on the basis of current knowledge it would be very difficult to identify a toxicological testing strategy or a biomonitoring approach for use in volunteer studies with smokers where the end-points determined or biomarkers measured were predictive of the overall burden of tobacco-induced adverse disease."
In other words ... our first hand smoke theory is so lame we can't even design a bogus lab experiment to prove it. In fact ... we don't even know how tobacco does all of the magical things we claim it does.
The greatest threat to the second hand theory is the weakness of the first hand theory.
Eww. Smokers are soooo gross. I guess if I had no choice but to take a smoker's lungs, I guess I would but still. NASTY!!!
Only about 20 percent of smokers actually develop the worst effects of smoking. I don't know if any of you have ever taken a smoker survey, but the surveys are totally biased.All the questions are vague or loaded. You could substitute the word milk and suddenly cows would be the cause of cancer. If you shave a mouses ass and paint ANYTHING on it every day it will probably get cancer. I would like to see what else those 20% did. FAT PEOPLE suck up way more medical resources than smokers. My grandmother died at 89. They put on her death certificate she died as a result of smoking, like being 89 had nothing to do with it! The doctor that told me he "loved smokers" cause he made his living off them dropped dead from a heart attact There's more old smokers than there are old doctors.
Here's my all-time favorite "scientific" study of the the anti-smoking campaign: "Lies, Damned Lies, & 400,000 Smoking-Related Deaths," Robert A. Levy and Rosalind B. Marimont, Journal of Regulation, Vol. 21 (4), 1998.
You can access the article for free on the Cato Institute's wesbite, Cato.org. This article neither defends nor promotes smoking. Rather it condemns the abuse of statistics to misinform and scare the public. Levy, by the way taught Statistics for Lawyers at Georgetown University Law School. There is also a popular law school class called How to Lie With Statistics.
You might also find this study of interest. It examines carcinogens in cigarette smoke and finds them insufficient to be a cause of cancer. Last sentence is the key one:
there is little reason to be confident that total removal of the currently measured human lung carcinogens would reduce the incidence of lung cancer among smokers by any noticeable amount.
My problem is COPD and my outlook is a near and certain demise. My doctor doesn't even mention transplants and I can't even get him to provide the pharmacy with timely scripts for my medication. I've run short on my advair a number of times. I would gladly go thru the transplant process rather than suffer through another exacerbation where I struggle with my breathing. I'm currently on 5 liters per min oxygen and I don't go anywhere without spare bottles so that my car sometimes resembles a emergency vehicle. I pray for death in my sleep rather than be awake during my oxygen struggle.
I wish that my doctor would be more forthcoming about my treatments rather than being just a pill pusher. I guess he figures there is no money in saving a life rather than treating sickness with pills. Who can I see about a lung transplant and would medicare cover the cost? Medicare? There lies the rub. Get in touch with me at rezcnay@hotmail.com. Thanks.
Frank, it all depends on how much profit is to be made by the Pharmaceutical companies since they donate to all teaching hospitals so the hospitals repay them by putting people on medications that mask the symptoms of many diseases but never cure the diseases since if they cured it, they would be out of business. It is obvious that in your case more money is made with keeping you on your current medication rather then giving you lung transplants which will give you roughly 5 to 10 years of life and still have to take pills to keep your body from rejecting the transplanted lungs, when you could live much longer and stay on their medications which will increase their bottom line and make their investors very happy.
I am sorry to put it in this manner since I know you are suffering to catch every breath you take but there is no cordial way of saying it. Good Luck Frank!
This pretty well destroys the myth of second hand smoke ehh!
Its nothing new in England theyve always done it but as it destroys tobacco control and its junk science of second hand smoke.......Its been buried until now. The effect this has is that smoking bans everywhere were based upon junk science and should be immediately REPEALED!
bull@!$%# i read a article of a person that had died after a lung transplant the lung was from a smoker !!!!
Yeppper and that was from organ rejection. There was one patient in England that got LC in the transplanted smokers lung. They couldnt see it had any problems even after biopsy and inspection.
The thing was smokers lungs are as pink as a non-smokers lungs to begin with! Theres no doubt non-smokers lungs can have LC in them already too! Its more prevalent now than ever before. BTW the lung transplant recipients LC was never identified as smokers LC via small cell or large cell carcinoma.
wonder how much they got paid to say i think the lungs are safe lets put them into people and find out
Let's see...Certain death by slowly strangling on my own mucus, or new lungs from one of the 80% of smokers who are not effected and the chance of several, perhaps many, additional years of life. Let me think....
Double lung transplant, December, 2011
Wow, some of you people are so annoying about anti-smoking that I want to start smoking just to piss you off! I understand 2nd hand smoke is dangerous, but most smokers these days are respectable about it - at least the ones I know, which is very few these days. I think some people need to watch a few episodes of mad men and realize just how much people used to smoke not all that long ago...get some perspective people! You're not going to convert everyone in to non-smokers overnight when it used to be a very popular thing to do!
Is the previous suppression of this info any wilder than the alleged suppression of the dangers of smoking by the tobacco companies? This is kinda like eggs - first it was terribly bad for you and then all of a sudden it wasn't. Seems like anyone with an agenda can come up with some study to cite.
There is a great deal more money spent on obese people as they have more health complications. Diabetes, heart attacks, strokes, copd, sleep apnea, high blood pressure, etc. American government researchers said that obesity is quickly overtaking smoking as the country's number one killer. In fact, obesity is
becoming such a problem that many experts now say it is compromising all the
benefits of recent improvements in health care and medical breakthroughs. If obesity continues to rise, by the year 2020, 20% of all health care spending
will be on obesity related diseases and conditions. This is according to the
Rand Corporation.
The American Health and Human Services Secretary,
said 'Americans need to understand that overweight and obesity
are literally killing us. To know that poor eating habits and inactivity are on
the verge of surpassing tobacco use as the leading cause of preventable death in
America should motivate all Americans to take action to protect their health. We
need to tackle America's weight issues as aggressively as we are addressing
smoking and tobacco.
kpa... life is killing us... or didn't you know?
obesity epidemic that was created like everything else to get public health laws enacted against us all!
Diabetes:
Old Definition: Blood sugar > 140 mg/dl
People under old definition: 11.7 million
New Definition: Blood sugar > 126 mg/dl
People added under new definition: 1.7 million
Percent increase: 15%
The definition was changed in 1997 by the American Diabetes Association and WHO Expert Committee on the Diagnosis and Classification of Diabetes Mellitus.
Hypertension:
High blood pressure is reported as two numbers, systolic or peak pressure and diastolic pressure when heart is at rest) in mm Hg.
Old Definition: cutoff Blood Pressure > 160/100
People under old definition: 38.7 million
New Definition: Blood Pressure > 140/90
People added under new definition: 13.5 million
Percent Increase: 35%
The definition was changed in 1997 by U.S. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
Prehypertension, a new category created in 2003: blood pressure from 120/80 to 138/89 includes 45 million additional people! If one includes this category, we have a grand total of 97.2 million total numbers of hypertensives and prehypertensives (whatever that is).
High (Total) Cholesterol:
Old Definition: Cholesterol > 240 mg/dl total cholesterol
People under old definition: 49.5 million
New Definition: Cholesterol > 200 mg/dl total cholesterol
People added under new definition: 42.6 million
Percent increase: 86%
The definition was changed in 1998 by U.S. Air Force/Texas Coronary Atherosclerosis Prevention Study.
Overweight:
Body Mass Index (BMI) is defined as the ratio of weight (in kg) to height (in meters) squared and is an inexact measure of body fat, though it supposedly establishes cutoff points of normal weight, overweight, and obesity.
Old definition: BMI > 28 (men), BMI > 27 (women)
People under old definition: 70.6 million
New definition: BMI > 25
People added under new definition: 30.5 million
Percent Increase: 43%
The definition was changed in 1998 by U.S. National Heart, Lung and Blood Institute.
"The new definitions ultimately label 75 percent of the adult U.S. population as diseased," conclude the two researchers.
...
I love how anti-smokers gripe at smokers and gleefully, happily, smugly talk about how they're going to die young. Well, I tell you what - my grandma's 92 years old, and I hope I'm long gone before I get to her age.
Go ahead and bust my chops about smoking. You can have my bed in the nursing home, my share of the Jell-o and Depends, and you can have my Alzheimer's. BTW: no one will visit you, because who wants to go out of their way to spend time with a b!tchy old person? And with as judgmental as some of you in this section are, you most definitely will be spending your old age alone. Please don't be shocked, because you only have yourselves to blame.
Enjoy your long, healthy, life. I'm going to enjoy my (statistically) shorter one. And if someone wants to receive my lungs, I'll donate them. If they don't want them because they belonged to an impure, unclean smoker, well then, that's their problem.
I recently heard of a story a women was given a lung in a transplant and then died the next year due to lung cancer! These studies are a waste of time and most smokers smoke more than a pack a day! This was a big waste of money.
Human lungs 'brush' themselves clean of contaminants
Friday, September 07, 2012 by: David Gutierrez, staff writer
Human lungs contain a tiny network of constantly moving "brushes" that flush contaminants out of the respiratory system, according to research conducted by scientists from the University of North Carolina and published in the journal Science.
Scientists have known for a long time that the respiratory system protects itself by means of a coating of mucus, which is sticky enough to trap pollutants and keep them from reaching the body's cells. When needed, the body can expel this mucus through a runny nose or a cough.
"The air we breathe isn't exactly clean, and we take in many dangerous elements with every breath," said lead researcher Michael Rubinstein.
"We need a mechanism to remove all the junk we breathe in, and the way it's done is with a very sticky gel, called mucus, that catches these particles and removes them with the help of tiny cilia. The cilia are constantly beating, even while we sleep.
"In a coordinated fashion, they push mucus, containing foreign objects, out of the lungs, and we either swallow it or spit it out. These cilia even beat for a few hours after we die. If they stopped, we'd be flooded with mucus that provides a fertile breeding ground for bacteria."
But until now, researchers have never understood why the mucus does not stick to or even infiltrate the respiratory cells themselves. The foremost theory, known as the "gel-on-liquid model," posited that an as-yet-undiscovered watery "periciliary" layer kept mucus and cilia separate. The problem with this theory was always that to the best of scientific knowledge, mucus should eventually dissolve into such a watery layer, not remain separate.
"We can't have a watery layer separating sticky mucus from our cells because there is an osmotic pressure in the mucus that causes it to expand in water," Rubinstein says. "So what is really keeping the mucus from sticking to our cells?"
"Gel-on-brush"
To get to the bottom of the mystery, the researchers used modern imaging techniques to examine the interior of the lungs. They found a dense network of brush-like structures that sit atop the cilia. These brushes are composed of protective molecules that keep both mucus and contaminants from getting to the respiratory cells beneath. These molecules also function as a second line of defense against viruses or bacteria that manage to penetrate the mucus.
Stephen Spiro of the British Lung Foundation said the findings could help significantly improve scientific understanding of lung function.
"Mucus has a complex biological make-up and forms a vital part of the lungs' defense mechanism," he said.
"Research such as this helps our understanding [of] how this system works, and of the complex mechanisms deep within our lungs which protect us from the atmosphere we breathe in."
Rubinstein and his fellow researchers noted that their findings may also explain previously mysterious lung disorders from asthma to cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). These diseases may stem from a collapse of the protective brushes.
"We found that there is a specific condition, below which the brush is healthy and cells are happy," Rubinstein said. "But above this ideal condition, in diseases like CF or COPD, the brush becomes compressed and actually prevents the normal cilia beating and healthy flow of mucus."
In such conditions, the mucus would then stick directly to the lung's cells.
"The collapse of this brush is what can lead to immobile mucus and result in infection, inflammation and eventually the destruction of lung tissue and the loss of lung function," Rubinstein said. "But our new model should guide researchers to develop novel therapies to treat lung diseases and provide them with biomarkers to track the effectiveness of those therapies."
The more I read, the more I am aggrevated with the Obama Administration. With Obamacare, 100% of smokers are going to be penalized for smoking although this article states that only 20% of smokers develope diseases associated with smoking. The American people are getting shafted every way they turn under this president unless of course they are getting entitlement benefits, i.e, welfare cash, food stamps, Medicaid which is better coverage then what most working people receive except of course the President, Congress and the Senate.
I collect Social Security after working most of my life, and it is a struggle to live from month to month, I can't even afford to purchase medical insurance supplement and can only hope that I do not get sick or hospitalized. Doctors are giving up their practices on a daily basis in anticipation of this Obamacare fiasco that might be shoved down our throats since they cannot live on what they are going to earn and the rest of our government is to afraid of Obama and his Chicago Gangsta style politics to do anything about it.