Abstract
Background
Liver transplant (LT) is a lifesaving treatment for patients with end stage liver
disease. Historically, institutions across the United States have deemed active marijuana
use as an exclusion criterion for listing. This study aims to investigate LT outcomes
in patients with history of marijuana use prior to LT.
Methods
We performed a retrospective review of 111 patients who tested positive for marijuana
on urine drug screen during initial LT evaluation between February 2016 and January
2021. 100 non-marijuana users who underwent LT were cross matched for control. Patient
demographics, substance use history, and transplant decisions were recorded. Post-LT
variables were also collected up to 1 year post surgery including postoperative infections,
issues with non-compliance, and continued substance use. Chi-square analysis was used
to assess the association between pre-transplant marijuana use and post-transplant
complications. Logistics regression was implemented to measure associations amongst
the entire cohort.
Results
From 111 marijuana users, 32 (29%) received a transplant. There was no statistical
difference in post-LT outcomes between marijuana and non-marijuana users, including
incidence of cardiac, respiratory, renal, psychiatric, or neurological complications,
as well as readmission rates post-surgery. There were no statistically significant
associations between marijuana use with post-transplant bacterial or fungal infections,
medication non-compliance, or continued substance use (all p>0.05). Marijuana use was associated with pre-LT tobacco use (p = 0.020).
Conclusions
Our data indicates that marijuana is not associated with increased risk of postoperative
noncompliance, other organ complications, infections, or death. As a single factor,
marijuana may not need to be a contraindication for LT.
Keywords
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Article info
Publication history
Published online: October 03, 2022
Accepted:
September 29,
2022
Received:
March 17,
2022
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
