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35th AM (2025) - Poster Session
Impact of Cannabis Use on Post-Transplant Outcomes ...
Impact of Cannabis Use on Post-Transplant Outcomes in Liver Transplant Recipients
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Pdf Summary
This scoping review examined the impact of cannabis use on outcomes following liver transplantation (LT) for end-stage liver disease (ESLD). ESLD, frequently caused by alcohol-related liver disease, often requires liver transplantation—an essential, life-saving intervention. Continued alcohol use post-transplantation increases mortality risk, and cannabis has been investigated as a possible therapeutic option to reduce alcohol consumption.<br /><br />The review included seven relevant studies, mainly retrospective and involving academic centers across the United States. Exclusions comprised case reports, reviews, non-English articles, and studies lacking focus on cannabis or liver transplant outcomes. The collective evidence revealed no clear association between cannabis use and immediate post-operative complications, patient mortality, or graft survival after transplantation. Specifically, four studies found no differences in immediate complications, six reported no difference in patient mortality, and two found no difference in graft survival based on cannabis use. However, three studies noted that cannabis use may increase the likelihood of liver transplant denial, suggesting it could act as a barrier to receiving a transplant in certain centers.<br /><br />Additionally, cannabis users exhibited higher levels of post-transplant substance use (excluding cannabis) in some studies but did not show differences in post-transplant survival up to 3 years, compliance, or readmission rates. Cannabis use was also associated with higher opioid use early post-operatively, yet without significant impact on hospital stay lengths or 90-day mortality.<br /><br />The review identified a gap in prospective research focused directly on long-term survival, graft function, and complications related to cannabis use. Consequently, it calls for further prospective studies to better elucidate the risks and benefits of cannabis use among patients with ESLD, particularly regarding its role in transplant candidacy and post-transplant outcomes.<br /><br />In summary, current data do not support a significant detrimental effect of cannabis use on liver transplant outcomes, but cannabis use may influence transplant eligibility. More rigorous and prospective research is needed to guide clinical decisions.
Keywords
cannabis use
liver transplantation
end-stage liver disease
alcohol-related liver disease
post-transplant outcomes
graft survival
transplant eligibility
substance use
opioid use
prospective research
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