Non-smoker receives donor lung from a smoker and dies from lung cancer

Implanted lung cancer risk from donor lung

Specialists recently examined a sad case from France. According to the medical report, a 39-year-old woman from France received a new lung, having suffered from cystic fibrosis since childhood. The donor organ came from a 57-year-old smoker who consumed 20 cigarettes daily for 30 years. Two years after the transplant, the woman with severe lung problems was admitted to the University Hospital Montpellier. The non-smoker was diagnosed with lung cancer. She died two months later.

A French panel of experts reported in a report on the risks posed by long-term smoker donations. They investigated a case in which a non-smoker died of lung cancer after having used the lungs of a smoker. The report was recently published in the journal "Lung Cancer".

A French medical team reports a case in which a non-smoker died of aggressive lung cancer after being implanted with the lungs of a smoker. (Image: satyrenko / fotolia.com)

Donor was a heavy smoker

A 39-year-old woman was admitted to the oncology department of the University Hospital Montpellier. Due to a life-long cystic fibrosis, she suffered from constant breathing difficulties and her respiratory capacity decreased progressively. Finally, in November 2015, a double lung transplant was performed. The donor register indicates that the donor lung came from a 57-year-old woman who smoked 20 cigarettes a day for 30 years a day. The organ was thoroughly examined by computed tomography for the presence of pulmonary foci prior to transplantation.

Two years later, fate takes its course

First, the condition of the patient improved. However, two years later she was admitted to the hospital again. She suffered from severe fever and severe breathlessness. 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 usually observed. Normally, the doubling rate for this type of tumor is about 600 days.

The woman with the donor organ had no chance

Within a short time several cancer foci had formed in the lungs and numerous metastases. The therapies all had no chance of success. The woman died two months later from the effects of lung cancer.

Mutation by smoking

Analyzes of tumor DNA revealed that a particular genetic mutation was responsible for rapid growth. This mutation is usually associated with smoking only. Professor Jean-Louis Pujol and his colleagues analyzed the case. They conclude that the immunosuppressive drugs that the patient had to take after the transplant are likely to be responsible for the accelerated growth.

Should lungs of smokers not be released for donation?

The authors of the report conclude that given the long latency period for lung cancer, it is not recommended to transplant a lung from long-term smokers, especially those who have recently quit smoking. (Vb)