Modified lung donor standards decrease mortality

EurekaAlert ^ | Public release date: 28-Oct-2003 | American College of Chest Physicians

[lockjaw02]

'Extended' criteria increase organ donations without compromising patient health

In a related study from the University of Texas Health Science Center, researchers evaluated the clinical outcomes of lung transplants in patients receiving either extended or standard donor lungs. Donors were considered "extended" if they met any of the following criteria: donor age of 55 or older, smoking history of more than 20 pack-years, having a history of pulmonary disease, chest radiographic changes, purulent sputum on bronchoscopy, or a decrease in oxygenation on 100 percent oxygen. Donors were matched with recipients, resulting in 20 patients receiving extended donor lungs and 11 patients receiving standard lungs. Recipients in both donor groups had similar outcomes in all posttransplant evaluation categories, including hospital and intensive care unit length of stay, length of intubation, readmission to the hospital, 6- and 12-month lung function tests, and 30-day mortality.

[lockjaw02]

It seems after years of being ostracized, smokers' lungs appear to be suitable for transplants and may even be desirable to help reduce waiting times for those needing transplants.

[Judith Anne]

Did you see that line, evidently no problem under 20 pack years? So, a pack a day habit for 20 years is not even considered as extended...

[lockjaw02]

ping

[lockjaw02]

Yes. I've been "engaged" with an anti-smoker for years who claims that a pack a day smoker inhales a quart of tar a year into their lungs and about a pint is retained. I keep asking her that if a pint is retained, and the lungs can only expel 3 pints per year, since the lungs only have about a 4 1/2 liter capacity, then what happens after 16 years when the lungs are full.

She always hems and haws, then changes the subject.

[Judith Anne]

Little by little, the truth about smoking comes out. Seems like the biggest frikken boondoggle in decades, this demonization of smoking. Sure made a lot of bleeping lawyers think they were rich. I doubt seriously that any child was deterred from smoking if they wanted to, by any money from these judgements, in spite of the bleeping propaganda.

Bleep them all, I say. Bleep the whole frikken bunch.

[lockjaw02]

LOL... Well you can bleep this one. Here's the tar jar lady.

http://www.thenownewspaper.com/045102/features/045102fe1.html

Nothing like trolling on the message boards, then calling it the "darkside of the internet", saying she's had threats, then writes a book full of bullshit to include the tar jar one pint a year retained in the lungs, and posts her face in the newspapers. She even wrote in her book that one cigarette delivers the same amount of radiation as one chest x-ray. I also keep asking her if 10,950 chest x-rays a year (10,980 on leap years, but who's counting) seem like an awful lot for a pack and a half a day smoker to be able to endure.

Something about her story just doesn't jive. A little sensationalism to push books, I presume. Also, they let her into schools to preach her misinformation. Be afraid. Be very afraid.

[Gabz]

Gee, so now they decide they will "accept" donor lungs from smokers?????

What this tells me is that they should have been doing so all along.

My "orders" are very specific - friends or family only until they stop the discrimination against smokers.

[Gabz]

I assume you are talking about the brain dead bigoted itch of the north????

The one that shows kids a quart jar of molasses or motor oil or something or other????

Liars always change the subject when they know they have been caught.

[Gabz]

I agree with you - bleep them all.

Now if only us normal folks could just get even a tiny percentage of the money they get for promoting their lies to get the actual truth out...........

[Gabz]

Yup - I was right.

Gee, how is it that I knew EXACTLY who you were talking about????

[lockjaw02]

You always could read my mind.

[Gabz]

SHHHHHHHHH

don't let anyone know - the big wind could be listening (heeheehee)

[lockjaw02]

Naw, she hasn't posted on the usual haunts since noon today. Probably packed her bags and is off on another whirlwind tour to target kiddies to hate the big bad smokers.

At least children are usually smart enough to know when something isn't right when they can't connect the dots.

[Gabz]

I have no idea where she posts anymore - because I don't care enough to even bother looking at the "usual haunts" that much any more.

Every once in a while, if I've had a particularly bad day or can't sleep or am drunk I go looking at them. Otherwise, I can't be bothered with the likes of her or her psychzoid sycophants.

[qam1]

"the waiting time for a lung transplant has increased as has the number of patients who die while waiting for a transplant...."

Jesus, God only knows how many people have suffered and/or died because of this stupid criteria. I swear the anti-smoking gnatzies are many times more dangerous to your health than cigarettes

I hope with this new common sense criteria they have an opt out list. I would love to see how strong the anti-smoking gnatzis convictions are if faced with the choice of

A) Taking a smoker's lungs
B) Death or at the very least living the rest of their pitful life in an Iron lung.

[lockjaw02]

I just have to wonder, with the non-smokers outnumbering smokers in the US by more than 3 to 1, why is there such a shortage of donated lungs available in the first place?

[Great Dane]

She always hems and haws, then changes the subject.

Funny, but typical. :-}

[dwills]

The tragedy occurs when a person with a propensity to nicotine addiction begins smoking at an early age and discovers later that they are particularly sensitive to the negative effects of smoking. Just a few cigarettes a day over a decade are enough to cause any of the lung, heart or circulatory effects to which some folks are vulnerable. In fact, for those who are susceptible, there's not much difference between a few or a pack per day.

These facts don't lead me to suggest that that the less risky smoker should subsidize the misfortune of the risky smoker through higher taxes or prices resulting from lawsuits, or that their freedoms should be restricted. Nevertheless, you should still discourage young people from smoking and, if you sense that you are vulnerable to the ill effects, refrain from smoking.

[qam1]

I just have to wonder, with the non-smokers outnumbering smokers in the US by more than 3 to 1, why is there such a shortage of donated lungs available in the first place?

Because smokers aren't necessary "Hogging" all the lungs, I believe the biggest number of recipents for Lung Transplants are people suffering from cystic fibrosis and lungs are fragile .

From the original paper that led to this study which loosened the criteria

Donor Criteria in Lung Transplantation: An Issue Revisited

"At any given time, approximately 3,500 people in this country are waiting for a lung transplant. Unfortunately, only 7 to 22% of multiorgan donors are deemed suitable to become lung donors,1 due to the fragility of the lungs in brain-dead patients and to the lung injury that occurs due to the trauma that often produces organ donors..."

Table 1. Standard Lung Transplant Donor Criteria

Age < 55 yr

ABO blood group compatibility

Clear chest radiograph

PaO2 300 mm Hg on fractional inspired oxygen of 1.0 and positive end-expiratory pressure > 5 cm H2O

< = 20 pack-year smoking history

Absence of chest trauma

No aspiration or sepsis

Gram stain shows sputum sample free of bacteria, fungus, and significant number of WBCs

[qam1]

There is even more B.S.

Successful outcome of lung transplantation is not compromised by the use of marginal donor lungs. June 1995

So they knew all this back in 1995 and did nothing,

20% or more of candidates for lung transplants do not survive to transplantation so for 8 years people have been dying needlessly.

Bastards,

There could be a case for a class action lawsuit against the antis with this.