Neyer Jonathan, Uberoi Abhimanyu, Hamilton Michele, Kobashigawa Jon A
From the Cedars-Sinai Heart Institute, Los Angeles, CA.
Circ Heart Fail. 2016 Jul;9(7). doi: 10.1161/CIRCHEARTFAILURE.115.002851.
There is no consensus within the heart transplant community about whether patients who use marijuana should be eligible for transplant listing, but several states have passed legislation prohibiting marijuana-using patients from being denied transplant listing based on their use of the substance.
We conducted an independent, voluntary, web-based survey of heart and lung transplant providers to assess current practice patterns and attitudes toward marijuana use in patients with advanced heart failure being considered for transplant. A total of 360 heart transplant providers responded from 26 countries. Nearly two thirds of respondents (n=222, 64.4%) supported listing patients with advanced, end-stage heart failure for transplant who use legal medical marijuana. Significantly, fewer respondents (n=96, 27.5%) supported transplant listing for patients using legal recreational marijuana. The majority of providers currently make patients eligible for transplantation after a period of abstinence from marijuana (n=241, 68.3%). There were no differences between the proportion of respondents supporting transplant listing after stratification by profession or country/region. Most (78.4%) survey respondents from states with laws prohibiting marijuana-using patients from being denied transplant listing reported denying all marijuana-using patients or mandating abstinence before transplant listing.
The majority of heart and lung transplant providers in our study sample supports the listing of patients who use medical marijuana for transplant after a period of abstinence. Communication and collaboration between the medical community and legislative groups about marijuana use in transplant candidates is needed to ensure the best patient outcomes with the use of scarce donor organs.
心脏移植界对于使用大麻的患者是否应符合移植登记条件尚无共识，但有几个州已通过立法，禁止因患者使用大麻而拒绝其移植登记。
我们对心肺移植提供者进行了一项独立、自愿的在线调查，以评估当前的实践模式以及对正在考虑进行移植的晚期心力衰竭患者使用大麻的态度。共有来自26个国家的360名心脏移植提供者做出了回应。近三分之二的受访者（n = 222，64.4%）支持将使用合法医用大麻的晚期终末期心力衰竭患者列入移植名单。值得注意的是，支持将使用合法消遣性大麻的患者列入移植名单的受访者较少（n = 96，27.5%）。大多数提供者目前在患者戒除大麻一段时间后使其符合移植条件（n = 241，68.3%）。按职业或国家/地区分层后，支持移植登记的受访者比例没有差异。在有法律禁止因患者使用大麻而拒绝其移植登记的州，大多数（78.4%）调查受访者报告称会拒绝所有使用大麻的患者，或要求在移植登记前戒除大麻。
我们研究样本中的大多数心肺移植提供者支持在患者戒除大麻一段时间后，将使用医用大麻的患者列入移植名单。需要医学界与立法团体就移植候选者使用大麻的问题进行沟通与合作，以确保在使用稀缺的供体器官时能为患者带来最佳结果。
