Lung transplant recipients who receive lungs from heavy drinkers are nearly 9 times more likely to experience primary graft dysfunction, according to a study published in the journal Alcoholism: Clinical and Experimental Research.
Lungs transplanted from heavy alcohol users also displayed poorer gas-exchange, and transplant recipients spent more time on ventilators. The study also found a trend toward poorer survival among patients who received lungs from heavy drinkers.
“We need to understand the mechanisms that cause this increased risk so that in the future donor lungs can be treated, perhaps prior to transplant, to improve outcomes.”
Previous studies have found that alcohol abuse increases the risk to drinkers of tuberculosis, pneumonia, and acute respiratory distress syndrome. The current study is the first to explore the impact of heavy alcohol use in lung transplant donors.
The study included 173 lung transplants performed at Loyola. Heavy alcohol use was defined as women who drank more than 3 drinks per day or 7 drinks per week and men who drank more than 4 drinks per day or 14 drinks per week. To be considered heavy alcohol users, donors also had to show either an abnormal liver biopsy or abnormal alcohol biomarkers.
Nearly 25% of the lung donors were heavy alcohol users. This is in line with previous studies that found that 23% of heart donors and 21% of kidney donors were alcohol dependent.
Researchers found that, after controlling for other risk factors, patients who received lungs from heavy alcohol users were 8.7 times more likely to develop severe primary graft dysfunction than patients who received lungs from donors who did not drink.
The researchers also found that during the first 24 hours after transplant, the ratio of oxygen carried in the blood to oxygen given to the patient was significantly worse in patients who received lungs from heavy alcohol users.
In an accompanying editorial, David Guidot, MD, Emory University School of Medicine, Atlanta, Georgia, wrote that the study “raises the question as to whether or not a history of heavy alcohol use by a potential donor should exclude the use of their lungs in transplantation. At a time when there is a critical shortage of lungs available for transplantation, this is obviously a problematic issue.
SOURCE: Loyola University Health System</p>
