According to the MNT... Lever Transplant recipients who smoke or have smoked increase their risk of viral hepatitis reinfection following liver transplantation according to new research available in Liver Transplantation, Findings suggest that tobacco in cigarettes may adversely affect immune
system response in patients transplanted for viral hepatitis.
According to the Centers for Disease Control and Prevention (CDC),
tobacco use causes more than five million deaths per year worldwide,
with estimates suggesting that annual mortality rates could climb to
more than eight million by 2030. Previous research reports that nearly
34% of liver transplant recipients are active or former tobacco users.
Moreover, medical evidence has shown that smoking increased biliary and
vascular complications in the short-term, and elevated risk of
all-cause, cardiovascular and sepsis-related mortality in the long-term
among those receiving livers.
"Organs available for transplantation are scarce, with livers
particularly in short supply," explains Dr. Mamatha Bhat from McGill
University in Canada. "Transplant centers need to take an active role in
identifying and minimizing risks to the success of liver
transplantation." In the present study, researchers assessed the impact
of smoking on incidence of complications, such as recurrent viral
hepatitis, following liver transplantation.
Analysis of demographic characteristics and post-transplantation
complications was performed on data from primary liver transplant
recipients over a 14-year period. Using data from the McGill University
Health Centre (MUHC) Liver Transplant database, the team identified 444
patients who received liver transplants between 1990 and 2004, of which
63 were repeat transplants. The mean age of liver recipients was 55
years and 66% were male with a mean body mass index (BMI) of 27.
Results show that 23% of transplant recipients were active or ex-smokers
and 78% were non-smokers. Of those who ever smoked, 78% were male and
88% were Caucasian. The cause of liver disease was likely to be alcohol
related in 29% of smokers or ex-smokers compared to 16% non-smokers.
Researchers estimated the median survival time for smokers following
transplantation was just over 13 years.
Further analysis shows that the recurrent viral hepatitis-free survival
time was less than one year for smokers and close to five years for
non-smokers. The team found that patient survival, and time to biliary
complications, first rejection and depression
post-transplantation was not linked to smoking status. However,
recurrent viral hepatitis-free survival was strongly associated with
smoking.
"Our findings suggest that recurrence of viral hepatitis may be more
frequent among liver transplant recipients who are active or former
smokers," concludes Dr. Bhat. "Encouraging preoperative smoking
cessation may be beneficial in improving patient outcomes following
transplantation." The authors stress
that their findings do not suggest the denial of liver transplantation,
but that transplant specialists be more vigilant in monitoring for
complications in those candidates who continue to smoke. They call for
validation of their results in larger studies that examine the effects
of smoking and other potential modifiable risks.
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