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已故器官捐献者使用大麻对供体培养阳性率及实体器官移植受者结局的影响。

Impact of deceased organ donor marijuana use on donor culture positivity and solid organ transplant recipient outcomes.

作者信息

Moore Krista, Lautenbach Ebbing, Blumberg Emily A, Han Jennifer, Lee Dong Heun, Clauss Heather, Hasz Richard, Bilker Warren B, Molnar Esther, Alimenti Darcy, West Sharon, Tolomeo Pam, Anesi Judith A

机构信息

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

Am J Transplant. 2024 Aug;24(8):1427-1439. doi: 10.1016/j.ajt.2024.02.022. Epub 2024 Feb 23.

Abstract

With the increasing prevalence of marijuana use in the US, many deceased organ donors have a history of marijuana use, raising concerns about infectious risks to transplant recipients. We performed a multicenter retrospective cohort study in which exposed donors were those with recent marijuana use (in the prior 12 months) and unexposed donors were those with no recent marijuana use. Primary outcomes included the following: (1) positive donor cultures for bacteria or fungi, (2) recipient infection due to bacteria or fungi within 3 months posttransplant, and (3) recipient graft failure or death within 12 months posttransplant. Multivariable regression was used to evaluate the relationship between donor marijuana use and each outcome. A total of 658 recipients who received organs from 394 donors were included. Recent marijuana use was not associated with donor culture positivity (aOR: 0.84, 95% CI: 0.39-1.81, P = .65), recipient infection (aHR: 1.02, 95% CI: 0.76-1.38, P = .90), or recipient graft failure or death (aHR: 1.65, 95% CI: 0.90-3.02, P = .11). Our data suggest that organs from donors with a history of recent marijuana use do not pose significant infectious risks in the early posttransplant period.

摘要

随着美国大麻使用的日益普遍,许多已故器官捐赠者都有大麻使用史,这引发了对移植受者感染风险的担忧。我们进行了一项多中心回顾性队列研究,其中暴露组捐赠者为近期(过去12个月内)使用过大麻的人,未暴露组捐赠者为近期未使用过大麻的人。主要结局包括以下几点:(1)捐赠者细菌或真菌培养呈阳性;(2)移植后3个月内受者因细菌或真菌感染;(3)移植后12个月内受者移植失败或死亡。采用多变量回归分析评估捐赠者大麻使用与各结局之间的关系。共有658名接受来自394名捐赠者器官的受者纳入研究。近期大麻使用与捐赠者培养阳性(校正比值比:0.84,95%置信区间:0.39 - 1.81,P = 0.65)、受者感染(校正风险比:1.02,95%置信区间:0.76 - 1.38,P = 0.90)或受者移植失败或死亡(校正风险比:1.65,95%置信区间:0.90 - 3.02,P = 0.11)均无关联。我们的数据表明,有近期大麻使用史的捐赠者提供的器官在移植后早期不会带来显著的感染风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2b6/11305974/4459ce1ecb58/nihms-1974113-f0001.jpg

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