Cigarette Smoke Exposure may Raise the Risk of Heart Transplant Defeat

Published on December 7, 2009 9:16 AM

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A recent study conducted at the University Of Maryland School Of Medicine in Baltimore supports the first direct evidence about heart transplant and cigarette smoke. Scientists found that the cigarette smoke exposure before a heart transplant in the donor, recipient, or both, accelerates the death of a transplanted heart.

They showed that tobacco smoke leads to quickened immune system refusal of the transplanted heart, heightened vascular inflammation and increased oxidative stress, and a reduction in the transplanted organ's chance of survival by 33-57 percent. The study was conducted in rats, including exposure to levels of tobacco equivalent to that of a usual, light-to-moderate-range smoker and included comparisons between smoking and non-smoking donors and recipients.

In this study, groups of donor and recipient rats were exposed to tobacco smoke while a control group of donors and recipients did not undergo any tobacco smoke exposure. To better separate the effect of smoking exposure from such factors as immunosuppression, the recipient rats in this study were not given medications to stop their immune systems.

Transplanted hearts not exposed to tobacco were rejected an average of eight days after transplantation. Donor hearts exposed to cigarette smoke were rejected at five days, while recipient smoke exposure extracted rejection at four days. Hearts in which both the donor and recipient were exposed to tobacco smoke lasted just three days before the immune response began destroying the transplant.

At the end of the investigation they understood that smoking in both the donor and the recipient should also become a part of the risk calculation in organ donation.

Mandeep R. Mehra, M.B.B.S., professor of medicine, head of the Division of Cardiology at the University of Maryland School of Medicine and chief of cardiology at the University of Maryland Medical Center, said: "Our research shows that if a heart donor has been an usual smoker, and you put that heart in a non-smoking recipient, that heart won't work; it will be rejected. This study shows beyond a shadow of a doubt how smoking affects transplantation."

Studies from the mid-1990s have shown a connection between cigarette smoking and cardiovascular diseases. But more recent studies have found a connection between smoking and the result of heart and other organ transplantation in recipients who resumed smoking after their transplants.

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine, explained: "The effects of smoking on heart health are well known and no surprise. The surprise in this study is the extent of the harmful effects of smoking on the transplanted heart. Our researchers have found an important connection that may lead to new ways to help patients with heart transplants live longer."

The researchers underlined that reduced survival happened indifferent of whether the heart donor or recipient smoked.