Donor Alcohol Use May Cause Lung Transplant Rejections

Alcohol abuse on the part of the donor increases the chance of a patient rejecting a lung transplant according to a recent study conducted at the Emory University School of Medicine. Regular consumption of alcohol can cause airway injury and scarring after a lung transplant, creating questions about the screening of lung donors.

"There is considerable evidence that alcohol abuse increases the risk for lung disease and lung injury," said David Guidot, MD, professor of medicine at Emory University School of Medicine and director of the Emory Alcohol and Lung Biology Center. "So it is a natural progression to look at lung transplants."

The results of this study will be published in the American Journal of Respiratory and Critical Care Medicine's December 1^st issue. The researchers used an animal model to conduct their research, but caution that their goal is to find out the affects of alcohol and ways to address those effects rather than limiting the pool of lung donors further.

"There are reasons to be concerned that chronic alcohol abuse by donors could increase the risk of complications in the transplanted lung," Dr. Guidot said. "Our goal is not to exclude donors, which would be the worst case scenario. Rather, it is to understand the biology, so that we can know how to intervene and make outcomes better."

According to statistics furnished by the United Network for Organ Sharing, one out of six organ donors are considered heavy drinkers. The UNOS defines heavy drinking as consuming two or more drinks per day, with organ donors tripling the rate of heavy drinkers found in the general population. Earlier research has idicated that heavy drinking affects the health of donor hearts, increasing the chance of heart failure.

For lung transplants, the rejection begins with obliterative bronchiolitis, which slowly disingrates the lung. The lung then becomes a mass of scar tissue and limits normal airflow. Most cases of obliterative brochiolitis occur within five years after the initial transplant.

"Chronic rejection remains the major barrier to successful lung transplantation and unfortunately, suppressing the immune system doesn't change the outcome," Dr. Guidot said.

Lung transplants are used to treat multiple advanced diseases, such as cystic fibrosis or emphysema. Because of the lack of donors, hundreds of people die each year waiting for a transplant. Only 1000 lung transplants are conducted each year off of a waiting list of 4000 patients
Source:

Emory University, "Alcohol may amplify chronic rejection in lung transplants" Eurekalert