Abstract
BackgroundWhile studies have shown that cigarette smoking has negative implications on the long-term outcome following liver transplantation, its role in early complications is inconclusive.MethodsThe clinical data of 162 consecutive adult patients who underwent elective liver transplantation from January, 2012 to March, 2016 were analyzed. Patients were defined as active smokers, ex-smokers, or non-smokers on the basis of documentation at the time of liver transplantation. The overall complications following liver transplantation were expressed as the comprehensive complication index (CCI). The specific complications such as the incidence of hepatic artery thrombosis, biliary complications, acute kidney injury were also assessed. A meta-analysis was carried out based on results from the present study and 11 published studies.ResultsWe found that cigarette smoking was not associated with higher CCI scores and smokers did not have a higher risk for developing hepatic artery thrombosis, biliary complications, acute kidney injury after liver transplantation. Meta-analysis confirmed the null association between cigarette smoking and an increased incidence of hepatic artery thrombosis or biliary complications in liver transplant recipients. However, the pooled results showed a significantly higher risk of cardiovascular diseases and de-novo malignancies in smokers following liver transplantation.ConclusionThere is not enough evidence supporting an association between cigarette smoking and early mortality and morbidity after liver transplantation. However, smokers should still be encouraged to quit before and after liver transplantation due to the long-term health benefits of smoking cessation.
Highlights
Cigarette smoking is the most common form of substance use worldwide
We found that cigarette smoking was not associated with higher complication index (CCI) scores and smokers did not have a higher risk for developing hepatic artery thrombosis, biliary complications, acute kidney injury after liver transplantation
Meta-analysis confirmed the null association between cigarette smoking and an increased incidence of hepatic artery thrombosis or biliary complications in liver transplant recipients
Summary
Cigarette smoking is the most common form of substance use worldwide. The deleterious sequelae of tobacco use are well recognized and the inherent health benefits of smoking cessation cannot be overstated. According to the World Health Organization, cigarette smoking was responsible for the death of 100 million people worldwide in the 20th century. It remains a major public health problem in the 21st century[1]. Cigarette smoking was found to be associated with serious long-term negative consequences including de novo malignancies and deceased patient and graft survival following liver transplantation[6,7,8,9], its role in early complications was inconclusive. While studies have shown that cigarette smoking has negative implications on the long-term outcome following liver transplantation, its role in early complications is inconclusive
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