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Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis

Background: The use of smoking donors (SD) is one strategy to increase the organ pool for lung transplantation (LT), but the benefit-to-risk ratio has not been demonstrated. This study aimed to evaluate the impact of SD history on recipient outcomes and graft alterations. Methods: LTs in 293 patient...

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Autores principales: Schiavon, Marco, Lloret Madrid, Andrea, Lunardi, Francesca, Faccioli, Eleonora, Lorenzoni, Giulia, Comacchio, Giovanni Maria, Rebusso, Alessandro, Dell’Amore, Andrea, Mammana, Marco, Nicotra, Samuele, Braccioni, Fausto, Gregori, Dario, Cozzi, Emanuele, Calabrese, Fiorella, Rea, Federico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199202/
https://www.ncbi.nlm.nih.gov/pubmed/34071675
http://dx.doi.org/10.3390/jcm10112400
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author Schiavon, Marco
Lloret Madrid, Andrea
Lunardi, Francesca
Faccioli, Eleonora
Lorenzoni, Giulia
Comacchio, Giovanni Maria
Rebusso, Alessandro
Dell’Amore, Andrea
Mammana, Marco
Nicotra, Samuele
Braccioni, Fausto
Gregori, Dario
Cozzi, Emanuele
Calabrese, Fiorella
Rea, Federico
author_facet Schiavon, Marco
Lloret Madrid, Andrea
Lunardi, Francesca
Faccioli, Eleonora
Lorenzoni, Giulia
Comacchio, Giovanni Maria
Rebusso, Alessandro
Dell’Amore, Andrea
Mammana, Marco
Nicotra, Samuele
Braccioni, Fausto
Gregori, Dario
Cozzi, Emanuele
Calabrese, Fiorella
Rea, Federico
author_sort Schiavon, Marco
collection PubMed
description Background: The use of smoking donors (SD) is one strategy to increase the organ pool for lung transplantation (LT), but the benefit-to-risk ratio has not been demonstrated. This study aimed to evaluate the impact of SD history on recipient outcomes and graft alterations. Methods: LTs in 293 patients were retrospectively reviewed and divided into non-SD (n = 225, group I), SD < 20 pack-years (n = 45, group II), and SD ≥ 20 pack-years (n = 23, group III) groups. Moreover, several lung donor biopsies before implantation (equally divided between groups) were evaluated, focusing on smoking-related lesions. Correlations were analyzed between all pathological data and smoking exposure, along with other clinical parameters. Results: Among the three groups, donor and recipient characteristics were comparable, except for higher Oto scores and age in group III. Group III showed a longer intensive care unit (ICU) and hospital stay compared with the other two groups. This finding was confirmed when SD history was considered as a continuous variable. However, survival and other mid- and long-term major outcomes were not affected by smoking history. Finally, morphological lesions did not differ between the three groups. Conclusions: In our study, SDs were associated with a longer post-operative course, without affecting graft aspects or mid- and long-term outcomes. A definition of pack-years cut-off for organ refusal should be balanced with the other extended criteria donor factors.
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spelling pubmed-81992022021-06-14 Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis Schiavon, Marco Lloret Madrid, Andrea Lunardi, Francesca Faccioli, Eleonora Lorenzoni, Giulia Comacchio, Giovanni Maria Rebusso, Alessandro Dell’Amore, Andrea Mammana, Marco Nicotra, Samuele Braccioni, Fausto Gregori, Dario Cozzi, Emanuele Calabrese, Fiorella Rea, Federico J Clin Med Article Background: The use of smoking donors (SD) is one strategy to increase the organ pool for lung transplantation (LT), but the benefit-to-risk ratio has not been demonstrated. This study aimed to evaluate the impact of SD history on recipient outcomes and graft alterations. Methods: LTs in 293 patients were retrospectively reviewed and divided into non-SD (n = 225, group I), SD < 20 pack-years (n = 45, group II), and SD ≥ 20 pack-years (n = 23, group III) groups. Moreover, several lung donor biopsies before implantation (equally divided between groups) were evaluated, focusing on smoking-related lesions. Correlations were analyzed between all pathological data and smoking exposure, along with other clinical parameters. Results: Among the three groups, donor and recipient characteristics were comparable, except for higher Oto scores and age in group III. Group III showed a longer intensive care unit (ICU) and hospital stay compared with the other two groups. This finding was confirmed when SD history was considered as a continuous variable. However, survival and other mid- and long-term major outcomes were not affected by smoking history. Finally, morphological lesions did not differ between the three groups. Conclusions: In our study, SDs were associated with a longer post-operative course, without affecting graft aspects or mid- and long-term outcomes. A definition of pack-years cut-off for organ refusal should be balanced with the other extended criteria donor factors. MDPI 2021-05-28 /pmc/articles/PMC8199202/ /pubmed/34071675 http://dx.doi.org/10.3390/jcm10112400 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schiavon, Marco
Lloret Madrid, Andrea
Lunardi, Francesca
Faccioli, Eleonora
Lorenzoni, Giulia
Comacchio, Giovanni Maria
Rebusso, Alessandro
Dell’Amore, Andrea
Mammana, Marco
Nicotra, Samuele
Braccioni, Fausto
Gregori, Dario
Cozzi, Emanuele
Calabrese, Fiorella
Rea, Federico
Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title_full Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title_fullStr Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title_full_unstemmed Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title_short Short- and Long-Term Impact of Smoking Donors in Lung Transplantation: Clinical and Pathological Analysis
title_sort short- and long-term impact of smoking donors in lung transplantation: clinical and pathological analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199202/
https://www.ncbi.nlm.nih.gov/pubmed/34071675
http://dx.doi.org/10.3390/jcm10112400
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