Patients who need new lungs are better off getting donated organs from smokers than none at all, even though they probably won't live as long as those who get a lung transplant from a non-smoker, a new study has found.
Researchers say patients will survive longer if they are willing to accept lungs from anyone, including smokers.
In Britain, that's a key issue because about 40 per cent of donated lungs come from people who have smoked.
Yet in recent years, several cases of British patients dying after getting lungs from smokers have sparked calls for the policy to be overhauled.
Doctors behind the new study said changing the UK transplant system would be wrong and lead to a spike in the number of people dying while waiting for donated lungs.
"That could deny patients the opportunity to get help," said Dr James Neuberger, associate medical director of the Queen Elizabeth Hospital in Birmingham and one of the study's authors.
Dr Neuberger and colleagues analysed information from the UK Transplant Registry and the Office of National Statistics on the survival rates of 2181 adult British patients waiting for lung transplants between 1999 and 2010. About two in five of those transplants came from smokers.
They found that patients who got lungs from smokers were about 46 per cent more likely to die within three years after getting the replacement lungs compared to patients who got the organs from non-smokers. But they had a 21 per cent lower chance of dying versus people who were still on the waiting list. The research was published today in the journal Lancet.
In the US, doctors also use lungs from smokers, although Dr Norman Edelman, the chief medical officer for the American Lung Association, does not have any data on how often that happens. The US and the UK have similar overall smoking rates of about 20 per cent.
Some experts said it was not realistic to expect organ donor systems to refuse lungs from smokers because the demand was such that nearly every usable lung was transplanted.
The key issues in lung transplants involve the size of the lung and the donor's blood type, which must match the recipients.
"There is rarely an 'ideal' organ available," Dr Edelman said.
He said most organs had defects based on factors like underlying disease or the age and circumstances of the donor's death.
"A smoker donor is really just one more factor to consider," he said.
In the UK, advocates have called for patients to be given more information about organ donors before accepting a transplant. In 2010, the family of a 28-year-old woman with cystic fibrosis lodged a complaint when she died a year after getting lungs from someone who had smoked for three decades. They said she had not been told and would have been horrified to get a smoker's lungs.
Dr Neuberger said patients had the right to refuse lungs from smokers as long as they understood the implications.
"I'd rather take the lungs from a smoker than get no lungs at all," he said.