Marijuana use in potential liver transplant candidates.


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.


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  • Authors

    Ranney DN

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

    Acker WB

    Al-Holou SN

    Ehrlichman L

    Lee DS

    Lewin SA

    Nguyen C

    Peterson SF

    Sell K

    Kubus J

    Reid D

    Englesbe MJ


    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


    Chronic Disease
    Cohort Studies
    Graft Survival
    Liver Diseases
    Liver Transplantation
    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



    PubMed ID