Research published in the Journal of the American Society of Nephrology (2000) has confirmed that cigarette smoking significantly increases a kidney transplant recipient’s likelihood of experiencing transplant failure and death. The study, conducted over 35 years on more than 1,300 renal transplant recipients in Minnesota, compared the outcomes of smokers with those who quit at least five years before transplant and those who never smoked. In light of the shortage of organs suitable for transplantation, the researchers raised questions about the moral and ethical responsibility of society to maximize the potential benefits of donated organs and concluded that transplant candidates should make serious attempts to quit smoking.
“These results just reinforce the clinical suspicion that cigarette smoking leads to adverse effects in any situation,” says Smita Shah, M.D., Co-Chief of the Pulmonary Section at Saint Barnabas Medical Center. Smoking increases the risk for cancer and heart disease and affects renal function for the general population, yet it may be even more dangerous for those who have received organ transplants and are at an already high risk for these complications, she explains.
The study concluded that smoking more than 25 pack-years at the time of transplant (the equivalent of smoking two packs of cigarettes a day for 12.5 years) was associated with a 30 percent higher risk of organ graft failure and a significant increase in the risk of cardiovascular disease.
For kidney recipients who quit smoking more than five years before transplantation, the risks for death or graft failure were significantly reduced. “This finding also confirms previous research on the general population that reveals that serious health risks decrease over a number of years after an individual quits smoking,” adds Dr. Shah. “Responsible organ transplant candidates are sensitive to important health issues, realize the benefit of simple preventative measures, and are willing to adopt these measures into their lifestyle.”
Kicking the Habit
In 1992, the Environmental Protection Agency classified cigarette smoking as a Class A carcinogen. It is the major cause of any type of lung cancer in both men and women. Fortunately, the overall population of smokers in the United States is declining, but statistics for teen smokers remain steady, with 3,000 new teens starting to smoke each day.
Individuals interested in quitting the habit should speak to their physician. The spontaneous quitting rate rose from 2 to 4 percent when a person’s physician simply raised the topic. Prescription medications are available to take away the craving for nicotine. Nicotine replacement is also available without a prescription, but all patches, gum and inhalers should be used cautiously. If a person continues to smoke while using these products, his or her exposure to nicotine is increased. “There are even some anecdotal reports about success with alternative smoking cessation therapies such as hypnotherapy and acupuncture,” adds Dr. Shah. In addition, Smoke Enders, the oldest and largest smoking cessation program in the country, is available through The Center for Health and Wellness at the Saint Barnabas Ambulatory Care Center by calling (973) 322-7444.
Dr. Shah adds that smokers should not get discouraged if they fail at smoking cessation. Statistics show that persistence pays, and the success rate increases with repeated attempts.
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