Cigarette Smoking and Its Hazards in Kidney Transplantation

Table 2

Summary of previous publications on implication of cigarette smoking on graft survival.

Number	Author	Journal/year	Findings
(1)	Kasiske and Klinger [37]	J Am SocNephrol/2000	Smoking more than 25 pack-years at transplantation (compared to smoking less than 25 pack-years or never having smoked) was associated with a 30% higher risk of graft failure (relative risk 1.30; 95% confidence interval [CI], 1.04 to 1.63; P = 0.021). Having quit smoking for more than 5 years before transplantation reduced the relative risk of graft failure by 34% (relative risk 0.66; 95% CI, 0.52 to 0.85; , 0.001)
(2)	Agarwal et al. [39]	Am J Nephrol/2011	(1) Past history of smoking in recipient did not have any impact on graft survival; (2) Current smoking had higher risk for graft failure compared to never smoking in renal transplant recipient (hazard ratio, HR = 3.3, 95% CI 1.5–7.1, )
(3)	Underwood et al. [29]	Clin Transplant./2014	Recipient smoking reduces graft survival (, )
(4)	Gombos et al. [40]	Transplant Proc. 2010	No difference in creatinine at 3 months, but creatinine at 1 year was significantly higher in smokers
(5)	Sung et al. [41]	Transplantation/2001	Patients who were smokers at the time of pretransplant evaluation had kidney graft survival of 84%, 65%, and 48% at 1, 5, and 10 years, respectively, compared with graft survival in nonsmokers of 88%, 78%, and 62% () Pretransplant smoking adversely affected death-censored graft survival in recipients of cadaveric () and of living donor kidneys (). In a multivariate analysis, pretransplant smoking was associated with a relative risk of 2.3 for graft loss
(6)	Hurst et al. [42]	Transplantation/2011	(1) Compared with never smokers, incident smoking after transplant was associated with increased risk of death-censored allograft loss (adjusted hazard ratio [AHR] 1.46 [95% confidence interval : 1.19–1.79];  ); (2) In a sensitivity analysis excluding patients with history of chronic obstructive pulmonary disease, similar results were obtained with increased risk of death-censored allograft loss (AHR 1.43 [95% CI: 1.16–1.76]; ) and death (AHR 2.26 [95% CI: 1.91–2.66]; )
(7)	Cosio et al. [34]	Clin Transplant./1999	Cox regression analysis showed significantly shorter graft survival in smokers ()
(8)	Matas et al. [43]	Ann Surg./2001	Pretransplant smoking was an important risk factor of a poorer long-term graft survival among recipients with 1-year graft survival (RR, 2.1)
(9)	Woo et al. [44]	J Nephrol/2002	Cox regression analysis showed that cigarette smoking was associated with graft failure having relative risk of 1.81
(10)	Kheradmand and Shahbazian [38]	Urol J/2005	Pretransplant smoking was significantly associated with reduced overall graft survival (), but no correlation between smoking cessation after transplantation with survival graft was found
(11)	Yavuz et al. [45]	Transplant Proc/2004	No significant relationship between pretransplant smoking and educational status (); graft loss; and smoking () was found
(12)	Mohamed Ali et al. [46]	Saudi J Kidney Dis Transpl./2009	The mean graft survival in patients who were smokers at the time of pretransplant evaluation was 89.3% compared with 92.5% in the nonsmokers ()