title: Recreational marijuana use is not associated with worse outcomes after renal transplantation.
abstract: As marijuana (MJ) legalization is increasing, kidney transplant programs must develop listing criteria for marijuana users. However, no data exist on the effect of MJ on kidney allograft outcomes, and there is no consensus on whether MJ use should be a contraindication to transplantation. We retrospectively reviewed 1225 kidney recipients from 2008 to 2013. Marijuana use was defined by positive urine toxicology screen and/or self-reported recent use. The primary outcome was death at 1 year or graft failure (defined as GFR<20 mL/min/1.73 m2). The secondary outcome was graft function at 1 year. Using logistic regression analyses, we compared these outcomes between MJ users and non-users. Marijuana use was not associated with worse primary outcomes by unadjusted (odds ratio 1.07, 95% CI 0.45-2.57, P=.87) or adjusted (odds ratio 0.79, 95% CI 0.28-2.28, P=.67) analysis. Ninety-two percent of grafts functioned at 1 year. Among these, the mean creatinine (1.52, 95% CI 1.39-1.69 vs 1.46, 95% CI 1.42-1.49; P=.38) and MDRD GFR (50.7, 95% CI 45.6-56.5 vs 49.5, 95% CI 48.3-50.7; P=.65) were similar between groups. Isolated recreational MJ use is not associated with poorer patient or kidney allograft outcomes at 1 year. Therefore, recreational MJ use should not necessarily be considered a contraindication to kidney transplantation.
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Garrett
authors.initials: G
authors.lastname: Greenan
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Sarwat B
authors.initials: SB
authors.lastname: Ahmad
authors.affiliation: Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Megan G
authors.initials: MG
authors.lastname: Anders
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Alexia
authors.initials: A
authors.lastname: Leeser
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Bromberg
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA. sniederhaus@smail.umaryland.edu.
authors.forename: Silke V
authors.initials: SV
authors.lastname: Niederhaus
mesh_terms: D000328:Adult; D000368:Aged; D000075204:Contraindications, Procedure; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D000074609:Marijuana Use / Q000009:adverse effects*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies
keywords: graft; marijuana; outcome; transplantation; use