Department of Surgery, The Dumont-UCLA Transplant and Liver Cancer, Division of Liver and Pancreas Transplantation, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Department of Medicine Statics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Clin Transplant. 2021 Apr;35(4):e14215. doi: 10.1111/ctr.14215. Epub 2021 Feb 17.
Increased societal prevalence of marijuana continues to challenge liver transplant (LT) programs. This study aimed to examine the potential effects of marijuana use on outcomes.
This retrospective study included recipients who underwent LT between 1/2012 and 6/2018. According to pre-LT marijuana use, patients were classified into recent (≤6 months of LT), former (chronic use but not ≤6 months), or non-users. Additionally, the impact of post-LT marijuana use on survival was assessed.
Of 926 eligible patients, 184 were pre-LT marijuana users (42 recent; 142 former) (median follow-up: 30.3 months). Pre-users were more likely to be male, White, and have histories of tobacco, alcohol, and illicit drug use. Additionally, recent users were of higher acuity, with higher MELD and requiring ICU admission. Patient survival at 1-year was 89% in non-users, 94% (HR: 0.494, 95% CI: 0.239-1.022 vs. non-users) in former users, and 83% (HR: 1.516, 95% CI: 0.701-3.282) in recent users. Post-operative complications in pre-LT users and the survival analysis for post-LT marijuana users vs. non-users did not show significance.
Our results demonstrated that marijuana use did not have an adverse impact on post-LT outcomes; however, further studies utilizing larger cohorts are warranted.
社会上大麻的流行率不断上升，这继续给肝移植（LT）项目带来挑战。本研究旨在探讨大麻使用对结果的潜在影响。
本回顾性研究纳入了 2012 年 1 月至 2018 年 6 月期间接受 LT 的受者。根据 LT 前大麻使用情况，患者分为近期（LT 后≤6 个月）、既往（慢性使用但不≤6 个月）或非使用者。此外，还评估了 LT 后大麻使用对生存的影响。
在 926 名合格患者中，184 名患者 LT 前使用大麻（42 名近期使用者；142 名既往使用者）（中位随访时间：30.3 个月）。非使用者更可能为男性、白人，有吸烟、饮酒和使用非法药物史。此外，近期使用者病情更严重，MELD 更高，需要入住 ICU。非使用者的患者 1 年生存率为 89%，既往使用者为 94%（HR：0.494，95%CI：0.239-1.022 与非使用者相比），近期使用者为 83%（HR：1.516，95%CI：0.701-3.282）。LT 前使用者的术后并发症和 LT 后大麻使用者与非使用者的生存分析没有显示出显著差异。
我们的结果表明，大麻使用对 LT 后结果没有不良影响；然而，需要利用更大的队列进行进一步研究。
