History of cigarette smoking and heart transplant outcomes

Background: Active cigarette smoking (CS) is a contraindication for Orthotopic Heart Transplantation (OHT) with a recommendation that HT candidates be free from CS for at minimum 6 months prior to HT. Animal studies have shown that a history of CS is associated with increased risk of allograft rejec...

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Published in:International journal of cardiology. Heart & vasculature 2020-10, Vol.30, p.100599-100599, Article 100599
Main Authors: Ohiomoba, R.O., Youmans, Q.R., Akanyirige, P.W., Ezema, A.U., Anderson, A.S., Bryant, A., Jackson, K., Mandieka, E., Pham, D.T., Raza, Y., Rich, J.D., Yancy, C.W., Okwuosa, I.S.
Format: Article
Language:English
Subjects:
Acute rejection
Cigarette smoking
Graft failure
Heart transplant
Infection
Malignancy
Mortality
Original Paper
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Summary:Background: Active cigarette smoking (CS) is a contraindication for Orthotopic Heart Transplantation (OHT) with a recommendation that HT candidates be free from CS for at minimum 6 months prior to HT. Animal studies have shown that a history of CS is associated with increased risk of allograft rejection, but few studies have examined the association of past CS and HT outcomes. Methods: Data were analyzed from HT recipients captured in the United Network for Organ Sharing (UNOS) transplant registry. Adults aged 18–79 who underwent HT from 1987 to 2018 and with data for all covariates (N = 32,260) were included in this study. The cohort was categorized by past smoking history (CS vs non-CS). Post-transplant outcomes of interest included survival, graft failure, treated rejection, malignancy and hospitalization for infection. Baseline characteristics were compared between the two groups using the chi-squared analysis. Unadjusted associations between CS and patient survival were determined using the Kaplan-Meier estimations and confounding was addressed using multivariable Cox proportional hazards models. Results: HT recipients with a history of CS were older (55 vs 50, p =
ISSN:2352-9067
2352-9067
DOI:10.1016/j.ijcha.2020.100599