A patient from England died 5 months after her double lung transplant. Her parents are now saying that she would have declined the transplant if she had known the donor was a 30 year smoker.
It is impossible to know if declining the lungs and waiting for non-smoker's lungs would have saved this patient. It is quite possible that even pristine lungs from a non-smoker would have ended in the same result. It is also possible that she could have died waiting for non-smoker's lungs that never became available. What I do know is that if the recipient was on the transplant list she was very sick, and patients get sicker as they wait, not better.
I can't imagine what this family is going through, but I can say that placing a blanket exclusion on transplanting the lungs of smokers would result in hundreds if not thousands of deaths each year. You see, all over the world people (who are not transplant professionals) are saying there should be a ban on transplanting the lungs of smokers.
Yes, people are saying that smoker's lungs should never be transplanted, that only non-smoker lungs are good enough to transplant, and more. Of course, not a single one of them is a pulmonologist, transplant surgeon, procurement coordinator or a transplant nurse.
As a transplant professional, these comments irk me to absolutely no end. Why? Putting a blanket exclusion on the lungs of smokers would mean approximately half as many people in America would receive a lung transplant... or put another way, many more would die waiting for a transplant that will never come.
Smoker's lungs are not the devil. If the donor was a marijuana smoker or a cigarette/pipe smoker it does not mean that the lungs are not transplantable. Many tests are done to evaluate the viability of every organ that is transplanted. For lungs, that means many blood tests to check the function, several bronchoscopies, lung recruitment techniques and more. All of this done to make sure that a life can be saved.
Are smoker's lungs used without a great deal of thought? No. They must pass the rigorous testing that non-smoker's lungs go through. Are non-smoker's lungs preferable? Almost certainly.
Here is another way to look at the issue, one that happens more frequently than anyone would like to think. Imagine you are the family member of a critically ill patient who is waiting for a lung transplant in the ICU. The doctors have told you that if lungs do not become available in the next 48 hours that your loved one will not make it. 24 hours later, the phone call you've been waiting for. Lungs are available, but the donor was a smoker. What would you say?
Sometimes, smoker's lungs are better than no lungs at all. In fact, for thousands, smoker's lungs are better than their very own lungs.
What do you think?
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