Are smoker's lungs fit for transplant?

Men and women are faced with a series of choices on a daily basis; some, obviously, with far greater consequences than others.

For example, a man choosing to wear white sport socks with a black suit will merely look silly. Of course, if he's married his wife will probably not let him leave the house. “Change your socks, Dear, they look silly,” she'll tell him. Whereupon, he will dutifully retire to the bedroom and change his damn socks wondering what all the damn fuss is about.

A married man who chooses to start an illicit office romance is faced with more devastating consequences; castration, for example. Or worse, divorce court which is itself a form of castration. Or so I'm told. Being married to the same woman for forty odd years has, thankfully, shielded me from some of life's more unpleasant experiences.

But, some choices have even more far reaching implications; literally, the difference between life and death.

Lyndsey Scott, 28, a cystic fibrosis sufferer, from Wigan (UK) was put on the transplant waiting list over four years ago. When donor lungs became available in February, 2009, she underwent double lung transplant surgery. There were serious complications from the start, and, tragically, she died of pneumonia in July of last year.

After reviewing her medical notes, her family made the “shocking” discovery that she had been given the lungs of someone who had smoked for 30 years.

The insinuation throughout most of the news media accounts I've read is that she died because the donor was a smoker. The bias is glaringly obvious in statements such as: ”Research has revealed around a quarter of donated organs are classed as higher-risk or ‘marginal’ – double the rate of a decade ago.”

The implication is that the “higher-risk or marginal” organs are those of smokers. Likewise, bias is evident in the claim that: “A shortage of donors is forcing surgeons to consider an increasing number of less healthy organs.” The insinuation, once again, is that the “less healthy” organs are those of smokers.

Of course, no evidence is presented to substantiate that not so subtle argument. And, then again, maybe I'm reading something into these news accounts that isn't there.

At any rate, it's estimated that almost 50% of donated organs come from smokers, despite the fact that they represent only 20% of the population. Chris Watson, vice-president of the British Transplantation Society (BTS), told CNN in an interview in December of last year that ”49 percent of last year's lung donors in the UK were smokers.”

Watson told CNN that data shows that transplants using smokers' lungs are just as effective in the long term as those using lungs from non-smokers. In other words, thousands of Britons are experiencing the benefits of receiving donor organs from smokers. But, as usual, it's the odd failure that gets the press.

Lyndsey's father, Allan Scott, is quoted as saying: “She would have been horrified to have known those lungs were from a smoker and quite definitely she would have refused that operation. She was always anti-smoking because of her condition.”

But, I wonder?

Faced with the prospect of dying on the waiting list (30% of those waiting for a transplant will suffer from such a fate) or taking the opportunity to extend your life for years, possibly decades, which would you choose? Would you really turn down the opportunity to live because you didn't want the lungs donated by a filthy smoker? Really?

From a personal point of view, I'm not particularly afraid of Death. I've had to stare the son-of-a-bitch down a couple of times in my life. And, the next time I may not be as lucky as on previous occasions. The rider on the pale horse is destined to win . . . eventually. But, I will not go quietly into the night. I'll go kicking and screaming every step of the way.

And, I'll likely go out with a fag in one hand and a tumbler full of Gordon Highlanders in the other.