Accepting a Lung Transplant from a Smoker Can Pose Less Risk Than Continuing to Wait

Should candidates for lung transplantation accept organs from donors who smoked? Using U.K. registry data on 1295 transplants that were performed between 1999 and 2010, researchers analyzed the effect of donor smoking on recipient survival after first adult lung transplantation. Further, they compared survival between 506 patients who accepted lungs from donors who smoked and, for each index case, all others who were on the transplant waiting list for at least as long as the index patient and who could have received the same lung.

Nearly 40% of transplanted lungs came from donors who smoked. Patients who received transplants from nonsmokers had significantly longer median survival (6.5 vs. 4.9 years) and significantly greater likelihood of s…