Evidence map›Paper›PMID 40278827›Full record

ArticleClinical transplantation2025

Lung Transplantation From Donors With a History of Substance Use.

David Li, Justin Weinkauf, Alim Hirji, Jason Weatherald, Rhea Varughese, Laura van den Bosch, Dale Lien, Jayan Nagendran, Kieran Halloran

Abstract read
In one paragraph

Article in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

David LiDepartment of Medicine, University of British Columbia, Vancouver, Canada.ORCID https://orcid.org/0000-0002-7512-9672
Justin WeinkaufDepartment of Medicine, University of Alberta, Edmonton, Canada.
Alim HirjiDepartment of Medicine, University of Alberta, Edmonton, Canada.ORCID https://orcid.org/0000-0002-6879-2345
Jason WeatheraldDepartment of Medicine, University of Alberta, Edmonton, Canada.
Rhea VarugheseDepartment of Medicine, University of Alberta, Edmonton, Canada.ORCID https://orcid.org/0000-0002-4328-0239
Laura van den BoschDepartment of Medicine, University of Alberta, Edmonton, Canada.
Dale LienDepartment of Medicine, University of Alberta, Edmonton, Canada.
Jayan NagendranDepartment of Surgery, University of Alberta, Edmonton, Canada.
Kieran HalloranDepartment of Medicine, University of Alberta, Edmonton, Canada.ORCID https://orcid.org/0000-0002-5615-6974

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSubstance use is common among lung transplant donors, but concerns persist about graft damage. Stimulant drugs such as cocaine and methamphetamine can induce pulmonary arterial hypertension, while smoked products such as cannabis and crack cocaine can produce airway and parenchymal diseases. We sought to characterize donor substance use at our center and evaluate the associations with recipient survival as well as chronic lung allograft dysfunction (CLAD), severe primary graft dysfunction (PGD3), and baseline lung allograft dysfunction (BLAD).

methodsWe studied patients with double lung transplants in our program between 2004 and 2016, including a history of donor substance use with nine pre-specified agents. We modeled the association with time to death or retransplant, CLAD, severe PGD, and BLAD.

resultsOf 473 recipients, 186 (39%) received lungs from a donor with a history of substance use with at least one of the pre-specified substances. There was no overall relationship between donor substance use and any outcome. Heavy donor smoking was associated with an increased risk of death or retransplant (hazard ratio 1.47; p = 0.032), PGD3 (odds ratio [OR]: 2.13; p = 0.014), and BLAD (OR 2.56; p < 0.001). Donor crack cocaine use (n = 24) was also associated with worse survival (HR 2.16; 95% CI 1.16-3.66; p = 0.017) but not CLAD or BLAD. We noted no CLAD associations with any drug.

conclusionA history of donor substance use was common and in general not associated with worse outcomes, aside from heavy donor smoking. These findings may have implications for allocation and post-transplant graft dysfunction.

Indexed as

Bronchiolitis Obliterans SyndromeCigarette SmokingDonor SelectionLung TransplantationPrimary Graft DysfunctionSubstance-Related DisordersTissue DonorsAdultAgedAllograftsFemaleFollow-Up StudiesGraft RejectionHumansLungMalebaseline lung allograft dysfunctionchronic lung allograft dysfunctiondonorlung transplantationprimary graft dysfunctionsubstance usesurvival

Identifiers

PMID40278827
PMCPMC12024647

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.