Should a non-smoker be given more priority over a person who smoked their whole life for a lung transplant?

Question

Do you think that, on a list of patients needing a lung transplant, a person who has never smoked once should be given priority over a person who has smoked their entire life?

Answer 1

I have Cystic Fibrosis, obviously never smoked, and had a double lung transplant 3 years ago. Even for me this is a difficult question.

Most people that have lung transplants do not have a history of smoking. Many are affected by other things such as occupational or environmental chemicals or other issues for which the cause has yet to be determined.

Part of my opinion is based on the history of smoking and the fact that over the course of my life time (I'm now 40 years old) smoking has gone from a commonly accepted thing to one that is now frequently frowned upon. Older people were raised in a different era with different thoughts regarding smoking so if they smoked at one point in their lives but have not smoked or used tobacco products for an extended period of time (say more than 10 years) then as long as they meet all the other lung transplant requirements I don't necessarily have an issue with it. On the other hand, if it's someone who was born in the 80's or later I would have a very different opinion of their smoking history.

Don't get me wrong, I detest smoking completely and have zero tolerance for it in terms of being around it. However, given a life and death decision I think all aspects of the patient's condition have to be taken into account.

Another thing to keep in mind is that some donor lungs are in better shape than others whether a result of something that happened to the donor while they were alive or something that damaged the lungs during their death. Patients that are eligible for lung transplant but considered 'high risk' would accordingly usually be given donor lungs that have a higher risk factor for successful transplant. A high risk patient status would be determined by their specific transplant center, but might, for instance, be someone who hasn't themselves smoked but their spouse and family smoke or their occupation exposes them to chemicals that will damage their lungs and they don't have other employment alternatives. That approach may have changed since the lung allocation policy changed a couple of years ago (went from waiting time on the list to sickest on list).

You've asked a great question.

Answer 2

I just have to respond to the answer above that states first come first serve. That is NOT the way it happens. I only waited for 2 months for my transplant. In the case of lung transplants, it is "the sickest one gets the lungs". Please read up on stuff before you post. Secondly this is a very very hard question. I have never ever smoked a day in my life and no I have never huffed paint either. It was very hard for me to accept that someone that chose to destroy there lungs might get lungs before I do when I was born with something that caused my lungs to fail. But now I believe that everything happens for a reason and God always has a plan. They might have chose to smoke but God has always known that person would be listed for transplant later in life. It all boils down to choices. A choice to smoke. A choice to have a transplant. UNOS doesn't discriminate based on race, status, age, or anything like that. It's a perfectly fair system.

Answer 3

I'm a smoker and it seems unfair that I should be given a lung first. There are people out there who were born with cystic fibrosis who need lung transplants. They didn't choose to destroy their lungs like I did. So, yes, I think non-smokers should be given priority.

Answer 4

I think the person that needs it the most should get it. Like if they don't get it today they will die. And someone who has a little longer can wait.

Answer 5

It should go like it is now. First come, first serve.

Answer 6

Yes! And I'm a smoker.

Answer 7

No, because they were probably huffing paint.

Answer 8

no, that would be discriminating!!