{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T16:40:05Z","timestamp":1749660005725,"version":"3.41.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Smoking has been shown to have detrimental effects on KT outcomes and survival. Most units and guidelines advocate for the cessation of smoking prior to a kidney transplant and consider it a general contraindication to listing. Smoking prevalence is higher in disadvantaged groups. Smoking cessation is complex and often takes many years. For those suffering from the burden of chronic kidney disease, a delay in transplantation with a longer dialysis time may result in worse outcomes and accentuate the difficulty of cessation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The objective of this study was to describe the cohort of excluded smokers for kidney transplantation (KT) and further examine the current practices regarding smoking and KT waitlisting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook a retrospective observational study of dialysis patients in Hunter New England Local Health District 2013\u20132023 &lt;65\u2009years old and assessed but not listed for KT. We examined the reasons for non\u2010transplant listing and divided them into two categories, smoking versus others (comorbidities, patient preference and cancer). We compared the categories in terms of demography, comorbidities and dialysis modality. We also conducted a survey of KT units across Australia and New Zealand regarding their policies towards smoking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We reviewed the records of 333 patients (142 female), 89 of whom were smokers. Patients not listed due to smoking were less comorbid than those rejected for another reason (83% vs 40% having \u22641 comorbid condition, <jats:italic>P<\/jats:italic> &lt;\u20090.001). Patients rejected due to smoking were younger than those rejected for other reasons (47.8 vs 52.1, <jats:italic>P<\/jats:italic> =\u20090.007). There was no difference between the two groups in terms of sex or dialysis modality. All the acute KT units were surveyed (response rate 100%); 72% of units do not list current smokers for KT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients not listed for KT due to smoking are generally younger and less comorbid than those not listed for other reasons. Our survey shows variation in practice between units. As smoking is more prevalent in marginalised communities, not listing these patients for KT may be an equity\u2010of\u2010access\u2010to\u2010treatment issue.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16627","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T08:36:07Z","timestamp":1737016567000},"page":"905-912","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Are we disadvantaging smokers by excluding them from kidney transplantation? A single\u2010centre experience and survey of kidney transplantation units"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4494-9088","authenticated-orcid":false,"given":"Humam","family":"Hazim","sequence":"first","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Rowlandson","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Chang","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Poon","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheridan","family":"Ward","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Howley","sequence":"additional","affiliation":[{"name":"Surgical and Perioperative Care Research Program Hunter Medical Research Institute  Newcastle New South Wales Australia"},{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Mackinnon","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department John Hunter Hospital  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"ANZDATA Registry.45th Report C. 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