Kidney and Hypertension Section, E.P. Joslin Research Laboratory, Joslin Diabetes Center, Boston, Mass.
Kidney and Hypertension Section, E.P. Joslin Research Laboratory, Joslin Diabetes Center, Boston, Mass.
Am J Med. 2019 Apr;132(4):413-419. doi: 10.1016/j.amjmed.2018.11.005. Epub 2018 Nov 17.
Tobacco smoking is the leading preventable cause of death worldwide. Both donor and recipient smoking have been shown to increase graft loss and mortality in solid organ transplant recipients in many studies. Only in lung transplants is smoking a universal contraindication to transplantation. Transplant centers implement different policies regarding smoking recipients and allografts from smoking donors. Due to scarcity of available allografts, the risks of smoking have to be weighed against the risks of a longer transplant waitlist period. Although transplant centers implement different strategies to encourage smoking cessation pre- and post-transplant, not many studies have been published that validate the efficacy of smoking cessation interventions in this vulnerable population. This article summarizes the results of studies investigating prevalence, impact on outcomes, and cessationinterventions for smoking in the transplant population. We report herein a review of the elevated risks of infection, malignancy, graft loss, cardiovascular events, and mortality in solid organ transplant populations.
吸烟是全球可预防死亡的主要原因。许多研究表明，供体和受体吸烟都会增加实体器官移植受者移植物丢失和死亡的风险。只有在肺移植中，吸烟才是普遍的移植禁忌。移植中心针对吸烟受者和来自吸烟供体的同种异体器官实施不同的政策。由于可供移植的同种异体器官稀缺，必须权衡吸烟的风险与更长的移植候补名单等待期的风险。尽管移植中心实施了不同的策略来鼓励移植前和移植后戒烟，但发表的验证这一脆弱人群中戒烟干预措施有效性的研究并不多。本文总结了研究吸烟在移植人群中的流行程度、对结局的影响以及戒烟干预措施的结果。我们在此报告了在实体器官移植人群中，感染、恶性肿瘤、移植物丢失、心血管事件和死亡风险升高的情况。
