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Tobacco Smoke Exposure in Either the Donor or Recipient Before Transplantation Accelerates Cardiac Allograft Rejection, Vascular Inflammation, and Graft Loss
Circulation, 10/23/09

Khanna AK et al. – These sentinel findings confirm that tobacco smoke exposure in either donors or recipients leads to accelerated allograft rejection, vascular inflammation, and graft loss. Molecular pathways that intersect as arbiters in this phenomenon include instigation of alloimmune activation associated with tobacco smoke–induced inflammation.

Exclusive Author Commentary
Mandeep R. Mehra, 10/27/09

These data provide confirmatory and mechanistic insight into clinical observations that suggest allograft loss due to accelerated coronary disease. In humans, the average life span of the transplanted heart is decreased by a median of 4.5 years in smokers. These current animal experiments also suggest that the donor heart may not work well from smokers even when the heart is removed and entered into a non-smoking environment. If confirmed clinically, these data will have donor use policy implications.

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