Non-smoker receives donor lung of smoker and dies of lung cancer

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Implanted risk of lung cancer from donor lungs
Specialists recently investigated a sad case from France. According to the medical report, a 39-year-old woman from France received a new lung because she had suffered from cystic fibrosis since childhood. The donor organ came from a 57-year-old smoker who consumed 20 cigarettes a day for 30 years. Two years after the transplantation, the woman with severe lung problems was admitted to Montpellier University Hospital. The non-smoker was diagnosed with lung cancer. She died two months later from the consequences.

In a report, a French expert panel clarified the risks posed by donor lungs from long-time smokers. They investigated a case in which a non-smoker died of lung cancer after being given a smoker’s lung. The report appeared recently in the journal “Lung Cancer”.

Donor was a heavy smoker
A 39-year-old woman was admitted to the oncology department of Montpellier University Hospital. Due to a lifelong cystic fibrosis, she suffered from constant breathing difficulties and her respiratory capacity decreased. In November 2015, a double lung transplant was finally performed. According to the donor registry, the donor lung came from a 57-year-old woman who had smoked 20 cigarettes a day for 30 years. Before the transplantation, the organ was thoroughly examined by computer tomography for the presence of lung foci.

Two years later fate takes its course
At first, the patient’s condition improved. However, just two years later she was admitted to hospital again. She suffered from severe fever and shortness of breath. The doctors diagnosed a particularly aggressive form of lung cancer. The tumor grew so fast that it doubled every 28 days, the doctors report. This is much shorter than is usually observed. Normally, the doubling rate for this type of tumour is about 600 days.

The woman with the donor organ did not stand a chance
Within a short time, several cancer foci had formed in the lungs and numerous metastases. The therapies had no chance of success. The woman died two months later as a result of lung cancer.

Mutation through smoking
Analyses of the tumour DNA showed that a specific genetic mutation was responsible for the rapid growth. This mutation is normally only associated with smoking. Professor Jean-Louis Pujol and his colleagues analysed the case. They concluded that the drugs used to suppress the patient’s immune defence after transplantation were probably responsible for the accelerated growth.

Shouldn’t smokers’ lungs be donated?
The authors of the report conclude that, given the long latency of lung cancer, it is not advisable to transplant a lung from long-term smokers, especially if they have recently given up smoking. (vb)

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