According to new research from the Loyola University Medical Center, recipients of lung donors with a heavy alcohol use history are at higher risk of developing severe primary graft dysfunction following lung transplant.
The study entitled “Heavy Alcohol Use in Lung Donors Increases the Risk for Primary Graft Dysfunction” was recently published in the journal Alcoholism: Clinical and Experimental Research.
Lung transplant recipients have high morbidity and mortality following transplantation, and heavy alcohol use is known to increase the risk of acute lung injury and the acute respiratory distress syndrome.
To examine if recipients of lungs from heavy drinkers would be more susceptible to lung injury following transplantation, Erin Lowery and colleagues retrospectively examined lung donor histories and transplant outcomes in 192 consecutive lung transplant recipients. Data was retrieved from the medical records of all patients who underwent lung transplantation between 2007 and 2011 at Loyola University Medical Center in Maywood, IL. Donors were classified as No Alcohol Use, Moderate Alcohol Use, or Heavy Alcohol Use.
Results revealed that the odds of developing severe primary graft dysfunction (PGD) in the Heavy Alcohol Use group versus the No Alcohol Use group were 8.7 times greater, after adjustment for PGD known associated factors.
Furthermore, lungs transplanted from heavy alcohol use group displayed poorer gas-exchange, and these lung transplant recipients were subsequently required to mechanical ventilation for a longer time following transplant. Moreover, those who were transplant recipients from the Heavy Alcohol use group were found to have a poor survival.
In a recent press release Dr. Lowery said, “Our findings could have implications for recipients of lung transplantation. We need to understand the mechanisms that cause this increased risk so that in the future donor lungs can be treated, perhaps prior to transplant, to improve outcomes.”
David Guidot, MD, of Emory University School of Medicine commented that Loyola study “raises the question as to whether or not a history of heavy alcohol use by a potential donor should exclude the use of their lungs in transplantation. At a time when there is a critical shortage of lungs available for transplantation, this is obviously a problematic issue. If other studies support the dramatically increased risk of primary graft dysfunction that Lowery and her colleagues have identified then the lung transplant professional community must confront this thorny question.”
Dr. Guidot stated that this study serves as a “call to action to develop treatments that can mitigate the effects of alcohol abuse on lung function and improve the donor pool.”