Abstract
Background: There is limited evidence that exposure to traffic related air pollution is associated with the development of chronic lung allograft dysfunction and graft failure among lung transplant recipients.
Objectives: The aim of the study is to explore associations between traffic related air pollution and transplant failure among lung and other solid organ transplant recipients in Great Britain.
Methods: All lung, heart, liver, and kidney transplants between 2000 and 2008 were included. Using residential postcode at time of transplant we calculated distance to nearest road, distance to nearest major road, as well as traffic intensity on nearest major road. In addition, annual average air pollution exposures were modelled for each transplant recipient, including nitrogen dioxide, nitrogen oxides and particulate matter (PM10, PM2.5 and PM-Coarse). Cox regression models were fitted to assess associations between each air pollutant and transplant failure after adjustment for age, sex, transplant year and donor age/smoking status.
Results: 780 lung, 1213 heart, 3650 liver and 11966 graft kidney transplant patients were included in the analysis. We did not find any consistent association between first lung, liver and kidney transplant failure and any of the analysed air pollutants. For heart transplants there was a borderline significant increased risk of transplant failure (HR 1.40, 95%CI: 1.01-1.95, p=0.045) for each increase in log NOx, however we found no increased risk in heart transplant failure for any other pollutants or exposure proxies.
Conclusion: Our analysis does not confirm associations between traffic related air pollution exposure and the risk of transplant failure as reported by previous studies.
- Copyright ©the authors 2016
