According to a study published in Liver Transplantation, liver transplant recipients who continue to smoke or have smoked in the past are more likely to acquire viral hepatitis reinfection after the procedure.
Each year, more than 5 million people in the world die due to tobacco use, according to the Centers for Disease Control and Prevention, and this figure is expected to increased to more than 8 million by the year 2030.
Earlier studies reveal that almost 34% of individuals who undergo liver transplantation are either current or former smokers. In addition, evidence has also shown that tobacco use increased biliary and vascular complications in the short-term, and also increase the risk of all-cause, cardiovascular and sepsis-related death in the long-term among liver transplant recipients.
Dr. Mamatha Bhat from McGill University in Canada, explained: “Organs available for transplantation are scarce, with livers particularly in short supply. Transplant centers need to take an active role in identifying and minimizing risks to the success of liver transplantation.”
In this study, the team evaluated the affect of smoking on incidence of complications, such as recurrent viral hepatitis, after liver transplantation.
After analyzing data from the McGill University Health Center (MUHC) Liver Transplant data, the researchers identified 444 individuals who underwent liver transplantation, of which 63 were repeat transplants. The procedures were performed between 1990 and 2004.
The researchers found that 78% of patients were non-smokers and 23% were current or former smokers. Of the 23% of current or former smokers, 88% were Caucasian and 78% were male. Alcohol was the primary cause of liver disease in 29% of current or former smokers versus 16% of non-smokers. The teams calculations indicated that the median survival time for smokers was just over thirteen years.
In addition, they found that the recurrent viral hepatitis-free survival time was nearly five years for non-smokers versus less than 1 year for current or former smokers. Although recurrent viral hepatitis-free survival was strongly linked with smoking, the team found no association between patient survival, and time to biliary complications, first rejection and depression after transplantation and smoking status.
Dr. Bhat concludes:
“Our findings suggest that recurrence of viral hepatitis may be more frequent among liver transplant recipients who are active or former smokers. Encouraging preoperative smoking cessation may be beneficial in improving patient outcomes following transplantation.”
According to the researchers their findings do not indicate the denial of liver transplant, but that specialists should concentrate more on monitoring for complications in patients who continue to smoke. They state that their findings need to be confirmed in larger studies that investigate the effects of smoking and other potential modifiable risks.
Written by Grace Rattue