Management of Opioid Agonist Treatment for Opioid Use Disorder in the Setting of Solid Organ Transplant

Joyal, Kayla; Peckham, Alyssa M.; Wakeman, Sarah E.; Zlotoff, Daniel A.; Lewis, Gregory D.; D’Alessandro, Donna M.; Crowley, Jerome; Waldman, G.

doi:10.1097/tp.0000000000003926

Cited by 3 publications

(1 citation statement)

References 12 publications

(21 reference statements)

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“…A recent article details crucial strategies for MAT integration into SOT [21 ▪▪ ]. Although all clinicians must be aware of a patients’ MAT, particularly their likely opioid tolerance requiring larger than average doses for adequate analgesia, SUD-oriented specialists’ awareness of prescribing details may help ensure interprofessional maintenance of adequate OUD care.…”

Section: Medication-assisted Opioid Use Disorder Treatmentmentioning

confidence: 99%

Substance use disorders in organ transplantation: perennial challenges and interprofessional opportunities

Winder¹,

Clifton²,

Mellinger

2022

Current Opinion in Organ Transplantation

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Purpose of reviewThe current article examines recent publications regarding ongoing clinical and ethical challenges and opportunities related to substance use disorders (SUD) in solid organ transplantation (SOT) utilizing a lens of interprofessional clinical models and care delivery.Recent findingsInnovative interprofessional clinician skillsets and care models are increasingly emphasized in the SOT literature as the standard of care for common, complex psychosocial problems like substance use and SUD. Cannabinoids are common among candidates and recipients and present several unique quandaries to SOT teams. Opioid use disorder treatment can often be definitively treated with medications that SOT teams may find unfamiliar, controversial, or aversive. Arguably the quintessential example of SUD in SOT, early liver transplantation for patients with alcohol-related liver disease and short periods of sobriety has become increasingly common and accepted in recent years requiring liver teams to rapidly acquire significant interprofessional psychiatric awareness and expertise. The question of retransplantation in patients who have experienced recurrent SUD remains unsettled.SummaryRegardless of substances used or organs transplanted, interprofessional care continues to emerge as a foundational aspect of clinical care and research in SOT.

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Section: Medication-assisted Opioid Use Disorder Treatmentmentioning

confidence: 99%

Substance use disorders in organ transplantation: perennial challenges and interprofessional opportunities

Winder¹,

Clifton²,

Mellinger

2022

Current Opinion in Organ Transplantation

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Pre-transplant Assessment and Post-transplant Management

Prager

2025

Massachusetts General Hospital Comprehensive Clinical Psychiatry

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Liver transplantation for alcohol-associated liver disease

Simonetto,

Winder,

Connor

et al. 2024

Hepatology

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Alcohol-associated liver disease (ALD) is a major cause of morbidity and mortality worldwide, and a leading indication for liver transplantation (LT) in many countries, including the US. However, LT for ALD is a complex and evolving field with ethical, social, and medical challenges. Thus, it requires a multidisciplinary approach and individualized decision-making. Short and long-term patient and graft survival of patients undergoing LT for ALD are comparable to other indications, but there is continued need to develop better tools to identify patients who may benefit from LT, improving the pre- and post-transplant management of ALD, and evaluating the impact of LT for ALD on the organ donation and transplantation system. In this review, we summarize the current evidence on LT for ALD, from alcohol-associated hepatitis (AAH) to decompensated alcohol-associated cirrhosis. We discuss the indications, criteria, outcomes, and controversies of LT for these conditions, and highlight the knowledge gaps and research priorities in this field.

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Management of Opioid Agonist Treatment for Opioid Use Disorder in the Setting of Solid Organ Transplant

Cited by 3 publications

References 12 publications

Substance use disorders in organ transplantation: perennial challenges and interprofessional opportunities

Substance use disorders in organ transplantation: perennial challenges and interprofessional opportunities

Pre-transplant Assessment and Post-transplant Management

Liver transplantation for alcohol-associated liver disease

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