Abstract

Concern exists that liver transplant center substance abuse policies may have an inappropriate and disproportionate impact on marijuana users. Our hypothesis is that patients with chronic liver disease who were marijuana users will have inferior survival. This is a retrospective (1999-2007) cohort study. The primary outcome measure is time-dependent, adjusted patient survival from the time of liver transplant evaluation. The primary exposure variable is a positive cannabinoid toxicology screen during the liver transplant evaluation period. Overall, 155 patients qualified as marijuana users while 1334 patients were marijuana non-users. Marijuana users were significantly (p < 0.05) younger (48.3 vs. 52.1), more likely to be male (78.1% vs. 63.0%), have hepatitis C (63.9% vs. 40.6%) and were less likely to receive a transplant (21.8% vs. 14.8%). Marijuana users were more likely to use tobacco, narcotics, benzodiazepines, amphetamines, cocaine or barbiturates (p < 0.05). Unadjusted survival rates were similar between cohorts. Upon multivariate analysis, MELD score, hepatitis C and transplantation were significantly associated with survival, while marijuana use was not (HR 1.09, 95% CI 0.78-1.54). We conclude that patients who did and did not use marijuana had similar survival rates. Current substance abuse policies do not seen to systematically expose marijuana users to additional risk of mortality.

Links

Publisher Full Text

Authors

Ranney DN, Acker WB, Al-Holou SN, Ehrlichman L, Lee DS, Lewin SA, Nguyen C, Peterson SF, Sell K, Kubus J, Reid D, Englesbe MJ

Institution

Department of Surgery Summer Research Group, University of Michigan, Ann Arbor, MI, USA.

Source

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 9:2 2009 Feb pg 280-5

MeSH

Chronic Disease
Cohort Studies
Female
Graft Survival
Humans
Liver Diseases
Liver Transplantation
Male
Marijuana Abuse
Marijuana Smoking
Middle Aged
Prospective Studies
Retrospective Studies
Survival Rate

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19067667