Smoking after heart transplantation: An underestimated hazard?

• Published in: European journal of cardio-thoracic surgery 1997-07, Vol.12 (1), p.70-74
• Main Authors: NÄGELE, H, KALMAR, P, RÖDIGER, W, STUBBE, H. M
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Carboxyhemoglobin - analysis; Female; Heart Transplantation - mortality; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Postoperative Period; Risk Factors; Smoking; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Survival Analysis
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(97)00156-5

OBJECTIVE: Risk factors for the development of vasculopathy and malignancies as the most important causes of morbidity and mortality after heart transplantation are not well defined. METHODS: Univariate and multivariate Cox regression analysis of the data derived from our 84 survivors of more than 3 months after orthotopic heart transplantation between 1984 and 1996. Measurement of carbonmonoxide-hemoglobin blood levels with an ABL 520 analyzer. RESULTS: Recipient or donor age, the mode of immunosuppression, total-, LDL- and HDL- cholesterol, the HDL/LDL-ratio,triglycerides, hypertension, diabetes mellitus, CMV status and rejection episodes had no independent influence on total mortality or the occurrence of graft vasculopathy or cancer. By means of an intensive questionnaire (incase of deceased patients, by their relatives) and measurement of CO-Hb blood levels we detected a high rate of patients who smoked after transplantation (22/84 = 26%). Four patients confessed smoking after undergoing the blood test. Non-smokers were defined as denying it in the questionnaire and having CO-Mb levels < 2.5% in repeated measurements.All but one were smokers before heart transplantation. Mean consumption was11 cigarettes per day. Five and 10 years survival was significantly reducedin smokers vs. non-smokers (37 vs. 80% and 10 vs. 74%, respectively, P