成人肝移植候选者和受者中的大麻使用情况。

Marijuana use among adult liver transplant candidates and recipients.

机构信息

Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.

Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.

出版信息

Clin Transplant. 2021 Jul;35(7):e14312. doi: 10.1111/ctr.14312. Epub 2021 Apr 19.

DOI:10.1111/ctr.14312

PMID:33829569

Abstract

BACKGROUND

Data regarding marijuana (MJ) use among liver transplant (LT) candidates are limited. We set out to determine the incidence and pre- and post-LT outcomes of adult LT candidates with a self-reported history of MJ use.

METHODS

Baseline clinical characteristics, waitlist, and post-LT outcomes of adult LT candidates from January 2010 to March 2017 were compared.

RESULTS

Among 2690 LT candidates, 630(23%) and 298(11%) reported a history of MJ use and use within the past 12 months, respectively. Although the proportion of MJ users increased over time(β = .76, p = .03), the proportion listed and transplanted did not change. Listing for LT increased with male (OR 1.24, 95% CI 11.01-1.52), MELD score (OR 1.08, 95% CI 1.01-1.15), HCC (OR 1.83, 95% CI 1.39-2.41) but decreased among MJ users (OR 0.67, 95% CI 0.50-0.91, p = .01). The median time to listing was longer among MJ users compared to non-users (115 vs. 87 days, p < .0005). Post-LT survival was similar in 83 MJ users and 306 non-users.

CONCLUSION

The proportion of MJ users among LT candidates is increasing. MJ users have a greater burden of psychosocial issues which may contribute to longer evaluations and lower rate of LT listing. Post-LT survival was not impacted by self-reported MJ use history.

摘要

背景

关于大麻（MJ）在肝移植（LT）候选者中使用的数据有限。我们旨在确定有自我报告大麻使用史的成年 LT 候选者的发生率以及 LT 前后的结果。

方法

比较了 2010 年 1 月至 2017 年 3 月期间成人 LT 候选者的基线临床特征、等待名单和 LT 后结果。

结果

在 2690 名 LT 候选者中，分别有 630（23%）和 298（11%）报告有大麻使用史和过去 12 个月内使用史。尽管大麻使用者的比例随时间增加（β=0.76，p=0.03），但列出和移植的比例并未改变。LT 列出的可能性随男性（OR 1.24，95%CI 11.01-1.52）、MELD 评分（OR 1.08，95%CI 1.01-1.15）、HCC（OR 1.83，95%CI 1.39-2.41）而增加，但在大麻使用者中减少（OR 0.67，95%CI 0.50-0.91，p=0.01）。与非使用者相比，大麻使用者的列表时间中位数更长（115 天与 87 天，p<0.0005）。83 名大麻使用者和 306 名非使用者的 LT 后生存率相似。