Recreational marijuana use is not associated with worse outcomes after renal transplantation

Abstract

As marijuana (MJ) legalization is increasing, kidney transplant programs must develop listing criteria for marijuana users. However, no data exist on the effect of MJ on kidney allograft outcomes, and there is no consensus on whether MJ use should be a contraindication to transplantation. We retrospectively reviewed 1225 kidney recipients from 2008 to 2013. Marijuana use was defined by positive urine toxicology screen and/or self-reported recent use. The primary outcome was death at 1 year or graft failure (defined as GFR<20 mL/min/1.73 m ). The secondary outcome was graft function at 1 year. Using logistic regression analyses, we compared these outcomes between MJ users and non-users. Marijuana use was not associated with worse primary outcomes by unadjusted (odds ratio 1.07, 95% CI 0.45-2.57, P=.87) or adjusted (odds ratio 0.79, 95% CI 0.28-2.28, P=.67) analysis. Ninety-two percent of grafts functioned at 1 year. Among these, the mean creatinine (1.52, 95% CI 1.39-1.69 vs 1.46, 95% CI 1.42-1.49; P=.38) and MDRD GFR (50.7, 95% CI 45.6-56.5 vs 49.5, 95% CI 48.3-50.7; P=.65) were similar between groups. Isolated recreational MJ use is not associated with poorer patient or kidney allograft outcomes at 1 year. Therefore, recreational MJ use should not necessarily be considered a contraindication to kidney transplantation.

Marijuana Consumption in Liver Transplant Recipients

“…Since California permitted the use of medical marijuana in 1996, followed by recreational legalization in the states of Washington and Colorado in 2012, there have been multiple studies evaluating its safety. Our study has shown, as have others, that marijuana should not be the sole reason to exclude a patient from transplantation because these patients have similar longterm outcomes and graft and patient survival as nonusers in both liver and kidney transplantation.…”

“…Medical marijuana has been successfully used to treat pruritus, chronic pain, depression, anorexia, sleep disturbance, and nausea, which are all symptoms that are consistently reported by pretransplant patients . However, neither medical marijuana nor recreational marijuana is regulated for purity or potency, leaving users potentially vulnerable to unpredictable medical efficacy and adverse effects.…”

Denying renal transplantation to an adolescent medical cannabis user: An ethical case study

“…The long‐term risk of medical cannabis use in renal transplant patients was examined recently by Greenan et al In a retrospective review of 1225 renal transplant recipients, the researchers found medical cannabis use was not associated with poorer patient or kidney allograft outcomes at 1 year. The primary outcome of survival at 1‐year post‐transplant did not differ between users and non‐users (100% vs 97.7%; P = 0.622).…”

Urine biomarkers in renal allograft

“…Renal allograft is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. [1] According to the Organ Procurement and Transplant Network (OPTN) records, nearly 85,000 candidates were on the waiting list for kidney transplantation in 2010, and ≈17,700 kidney transplantations (including 828 kidneypancreas transplantations) were performed. [2] The data from the United States Renal Data System (USRDS) shows that currently approximately one in three donations is from a live donor.…”