Cigarette Smoking and Kidney Transplantation Don’t Mix
Transplant Program Has No-Smoking Policy for Kidney Transplant Candidates
by Steven Katznelson, M.D., medical director, Kidney Transplant Program, California Pacific Medical Center and Laura Miyashita
Cigarette smoking is widely acknowledged to cause medical problems including cancer, heart attacks and stroke. Smoking is also associated with a high risk of kidney disease. Accordingly, research shows that smoking puts both transplant patients and their transplanted kidneys at risk.
“People who smoke at the time of transplant have a nearly 100% increased risk of developing cancer and suffering a major cardiovascular event (heart attack and stroke) after transplantation as compared to people who do not smoke,” says Steven Katznelson, M.D., medical director of California Pacific Medical Center’s Kidney Transplant Program. He adds, “It has also been established that smoking can lead to an increased risk of rejection and a 30% increased risk of kidney transplant loss when compared to those who do not smoke.”
Smoking Cessation Necessary for Transplant
Because of the negative impacts of smoking on one’s transplant outcome, most transplant programs will not offer kidney transplantation to individuals who continue to smoke. “At California Pacific Medical Center, we agree that cigarette smoking puts patients at excessively high risk of severe problems following transplant,” says Katznelson. “We mandate that all patients prove they have quit smoking before they are offered a transplant.”
If individuals are smoking at the time of their transplant evaluation, they are required to enter into a six-month no-smoking contract with the Kidney Team if they wish to pursue a kidney transplant. This includes agreeing to intermittent blood testing. They will also be referred to their local health care team to help them enter a smoking-cessation program.
article published in October 2009 Kidney Review newsletter