The following is the summary of “Outcomes of lung transplantation from donors with a history of substance abuse” published in the January 2023 issue of Thoracic and cardiovascular surgery by Donahoe, et al.

The purpose of this research was to examine the relationship between the donor’s substance misuse (opioid overdose death, opioid use, cigarette or marijuana smoking) and the recipient’s lung acceptance and outcomes. Lung acceptance rates and recipient outcomes were analyzed from 2013 to 2019 to see if donor substance usage played a role.Over the course of the research, there were 3,515 potential donors. 154 (4%) of the requests included opioid use, while 117 (3%) were fatal overdoses caused by opioids. 

There were 1,744 smokers among the donors (65.0%) and 69 pot smokers (2.6%). Of the total number of smokers, 1117 (65.0%) had smoked for at least 20 years, whereas 601 (35.0%) had smoked for fewer than 20 years. Donors who had abused drugs were younger (51.5 vs. 55.2, P<.001), more frequently male (65.6 vs 54.8%, P<.001), more commonly White (86.2 vs 68.7%, P<.001), and more likely to have hepatitis C (8.3 vs 0.8%, P<.001). Brain-dead donors (odds ratio, 1.56, P<.001), donors with a smoking history (odds ratio, 0.56), donors with hepatitis C (odds ratio, 0.35), younger donors (odds ratio, 0.98, P<.001), male donors (odds ratio, 0.74, P=.004), and donors with a history of substance abuse (odds ratio, 0.50 Lungs from donors who died of an opioid overdose, smoked marijuana, or smoked cigarettes for less than 20 patient-years or more than 20 patient-years all resulted in similar recipient survival rates, however recipients of lungs from donors who used opioids lived substantially longer. 

Patients who got lungs from donors who died of an opioid overdose or had a history of opioid use, marijuana use, or cigarette use had similar times to chronic lung allograft malfunction. Cigarette smoking was associated with less donor acceptance than either opioid usage or death from an opioid overdose, but both were associated with higher acceptance rates than marijuana use. In addition, lung transplant recipients who received organs from substance abusers had similar graft results and survival rates.

Source: sciencedirect.com/science/article/abs/pii/S0022522322009059