Newswise — Following the recent news of the double lung transplant performed on a young patient whose lungs were irreparably damaged from vaping, Keith S. Naunheim, MD, from Saint Louis University, shares his thoughts on transplantation for smokers.
Does this case open any new ethical considerations for how vaping illnesses will be treated/handled?
“One can never tell for certain, but probably not. The medical profession does not withhold care from patients even when their health problems are self-imposed (suicide attempts, drug abuse complications, alcohol abuse complications, cigarette smoking complications, etc.). This includes transplantation services in which organs are allocated to patients with end stage failure regardless of whether the damage is or is not self-imposed.”
Has this type of procedure been considered for smokers in the past and how are those decisions made?
“Cigarette smokers with end stage lung disease have many medical problems (pneumonia, lung failure, collapsed lungs, etc.), and these are aggressively managed with ventilatory support as well as occasional ECMO (extracorporeal membrane oxygenation) and/or transplantation.”
Did this patient’s age factor into his getting a new set of lungs?
“While it is true that some patients are too old and frail to be considered for lung transplantation, age alone is not a deciding factor. This patient would be just as likely to get a lung transplant if he were 27 or 37 or 57 years old. The allocation algorithm did take into account the acuity of his disease and the extreme clinical situation.”
Will lung transplants be considered or performed on vapers more often, given that vaping is such as scourge on young folks?
“I believe vaping patients will be considered in exactly the same fashion as cigarette smokers and other folks with end stage lung disease. The overriding ethical principle is that all human life is precious and worthy of saving when possible, even if the injury is self-inflicted.”
WHO: Keith S. Naunheim, MD, Professor and Chief of Cardiothoracic Surgery at Saint Louis University; past president of The Society of Thoracic Surgeons
WHY: The U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention (CDC) are working together with state and local public health partners to investigate the incidents of severe respiratory illness related to the use of vaping products.
As of November 13, 2019, 2,172 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to the CDC; 42 deaths have been confirmed.
In many cases, patients reported a gradual start of symptoms, including breathing difficulty, shortness of breath, and/or chest pain before hospitalization. Some cases reported mild to moderate gastrointestinal illness including vomiting and diarrhea, or other symptoms such as fevers or fatigue.
Dr. Naunheim is available to speak with the media about concerns associated with vaping.
CONTACT: Jennifer Bagley, The Society of Thoracic Surgeons, 312-202-5865, firstname.lastname@example.org