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    Smoking—An Unacceptable Risk for Transplant Patients

    Transplant Failure Much Higher for Those Who Smoke

    With all of the warnings now present on cigarette packages and advertisements, it has become common knowledge that smoking is a major risk factor for developing life-threatening health problems such as cancer and heart disease. It is also likely that cigarette smoking has an adverse effect on kidney function. Though the general population has known about the risks of smoking for some time, the proof that smoking causes severe health problems in kidney transplant recipients has come only recently.

    Kidney transplant recipients are already at high risk for developing cancer and heart disease. This risk comes from related problems that patients with end-stage renal disease often have: diabetes, hypertension, high cholesterol levels and a clinical history of heart attack, stroke or peripheral vascular disease. Additionally, some of the anti-rejection medications needed after transplant can cause or enhance some of these risk factors.

    Data Shows Problems Associated with Smoking

    Recent scientific literature suggests that smoking before or after transplant can lead to a number of profound and avoidable medical problems:

    • Those who smoke at transplant time have a 30% higher risk of transplant failure compared to patients who do not smoke.

    • Those who quit smoking more than five years before transplant reduce their risk of transplant failure by 34% as compared to patients who continue to smoke.

    • When compared to patients who do not smoke, those who smoke before transplantation have up to a 91% increased risk of developing aggressive forms of cancer and a 114% increased risk of suffering a major cardiovascular event (such as a heart attack or stroke) after transplantation.

    • Smoking may also lead to an increased risk of acute transplant rejection.
    Because quitting smoking long before transplantation has so many advantages, California Pacific’s Kidney Transplant Program requires this. This policy, which is similar to that of many transplant programs nationwide and which is required by many insurers, dictates that patients who are smoking enter a six-month “no smoking contract.” Our Kidney Team will perform intermittent blood testing and refer patients who smoke to their local health care team for enrollment in a smoking-cessation program. Some assistance will also be available from California Pacific’s Transplant Program.

    Good kidneys for use in transplantation are a scarce resource. Therefore, it is imperative that each kidney recipient and kidney be given the best chance at success. For smokers, this means that smoking cessation is critical.

    For tips on quitting smoking, visit the American Lung Association website.

    About California Pacific Medical Center

    California Pacific Medical Center, part of the Sutter Health network, offers kidney, pancreas, liver and heart transplantation as part of our Barry S. Levin, MD Department of Transplant.

    Kidney & Pancreas Transplant Program
    California Pacific Medical Center
    2340 Clay Street
    San Francisco, CA 94115
    Tel. 415-600-1070

    Outreach locations available throughout Northern California and in Reno.