Although associations may in part reflect underlying conditions or behaviors, high levels of prescription opioid use before kidney transplantation predict increased risk of posttransplant death and graft loss.

Background The impact of mechanical ventilator support (MCVS) on mortality and graft loss after liver transplantation (LT) is not well-described. Methods Multivariate analysis of a novel database linking national transplant registry and Medicare claims data was used to assess the impact of early MCVS on mortality and graft survival following LTs performed between 2002–2008. Results Among 10,517 LT recipients, 6.9% (n=726) required post-operative MCVS, 25.6% of who required < 96 hrs, 24.2% ≥ 96 hrs, and 50.1% an unspecified duration. Significant predictors of prolonged MCVS included older age, female gender, pre-transplant dialysis requirement and ascites. After multivariate adjustment, MCVS ≥96hrs was associated with nearly 3-times the adjusted hazard ratio (aHR) of mortality (2.95, P=<0.001), while MCVS <96 hrs was not significantly associated with mortality (aHR 0.88, P=0.55). Conclusions Recognition of LT patients at-risk for prolonged MCVS may help to reduce the incidence and consequences of this complication.

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