Any history of smoking before a live donor renal transplant is associated with impaired graft and patient survival and an increased risk of early rejection, according to a study.

Joseph M. Nogueira, MD, and colleagues at the University of Maryland School of Medicine in Baltimore, studied 997 laparoscopic live donor kidney transplant recipients, of whom 329 had ever smoked and 668 had never smoked.

Smokers had a 47% increased risk of graft failure and a 60% increased risk of death compared with never smokers, after adjusting for potential confounders, the investigators reported in the American Journal of Kidney Diseases (published online ahead of print). In addition, smokers had a 46% increased risk of acute rejection in the first year and a nearly twofold increased risk of rejection on or before posttransplant day 10.

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“This study of nearly 1,000 live donor kidney transplant recipients shows that ever smoking is independently associated with worse long-term kidney transplant survival,” the authors wrote.