A new federally funded study examining the potential risks of organ donation by marijuana users finds that even though many health care providers continue to restrict transplants to cannabis consumers, recent cannabis use However, no signs were found that increased the likelihood of serious side effects during the first year after transplantation.
The results of the study, which looked at recipient infection rates, transplant failure rates, and mortality rates, “suggest that organs from donors with a recent history of marijuana use do not pose a significant risk of infection early after transplantation.” .
“Despite concerns that donor marijuana exposure increases the risk of fungal infections in recipients, our study found that donor history of marijuana use was associated with (1) positive donor cultures (including respiratory cultures); (2) We found no increased risk of infection, or (2) risk of early recipient bacterial or fungal infection, graft failure, or post-transplant death,” the authors wrote. . “Even when evaluating only lung recipients, we found no association between donor marijuana use and risk of post-transplant infection.”
As more states legalize marijuana, reported rates of adult use are rising, according to a new study published late last month in the American Journal of Transplantation. “Although it is likely that an increasing proportion of deceased organ donors had a history of marijuana use, this indicator is not specifically reported,” the report said.
“Our data suggest that organs from donors with a recent history of marijuana use do not pose a significant risk of infection early after transplantation.”
Infectious disease is a major concern, it continues, pointing to past findings that marijuana leaves themselves can be contaminated with potentially dangerous bacteria and fungi. Inhaled marijuana has been associated with certain infections in transplant recipients, while bacterial outbreaks have also been associated with marijuana use in nontransplant recipients.
What is less clear is whether organs from marijuana users may pose a risk to transplant recipients.
“Is there a risk of SOT in deceased organ donors with a history of marijuana use?” [solid organ transplant] “Recipients have not been clearly evaluated,” the paper said, and “no studies have determined the effect of marijuana use by SOT donors on donor culture results and the risk of donor-derived infection (DDI) in recipients.” It has said.
The authors write, “The aim of our study is to better characterize the infection risk that marijuana use by deceased organ donors may pose to SOT recipients.”
It was conducted by researchers from the University of Pennsylvania, the University of California, San Francisco, Temple University, and the Gift of Life Donor Program. study We looked at data from three transplant centers in Philadelphia. This includes transplants involving organs procured through the Gift of Life Program between January 1, 2015 and June 30, 2016. This research was funded by the Innovative Research Grants Program of the National Institutes of Health, Centers for Disease Control and Prevention, and the Transplant Foundation.
Transplants are removed from recent cannabis users if toxicology screening shows the presence of THC or if a next of kin or donor informant reports that the donor has a history of cannabis use within the past 12 months. was defined as that of
Researchers analyzed data from hundreds of organ transplants and determined whether cultures from the donors themselves tested positive for bacterial or fungal infections and whether organ recipients developed new bacterial or invasive infections. Three primary outcomes were assessed: whether a fungal infection developed and whether the transplant caused graft failure or recipient death. . For each outcome, no significant increased risk was found involving donors with a history of recent cannabis use.
For example, “79 (89%) of donors with a recent history of marijuana use had at least one positive culture, compared to 264 (87%) of donors with no history of marijuana use. ” states the report. “Respiratory cultures of donors showed no bacterial or fungal growth in 76 donors (85%) with a history of recent marijuana use and 250 (82%) without a history of recent marijuana use. There was no association between donor recent marijuana use and donor culture positivity in both unadjusted and multivariate analyses.”
Notably, this study did not take into account the amount or duration of marijuana use by the donor. The authors also note that this study had a smaller cohort of lung transplant recipients than previous studies, and “showed mixed results.”
The report acknowledged that relying on interviews with next of kin and donor informants was an “imperfect measure” of donors’ actual cannabis use, but added that it “separated exposure groups from THC toxicity. When restricted to the group with a positive clinical test, no association remained between donor culture results or recipient results.
“In conclusion, our study shows that donors with a history of recent cannabis use are no more likely to have a positive donor culture and that their recipient will develop a bacterial or fungal infection, graft failure, or infection. “This suggests that this is not likely,” they wrote. Early post-transplant death (in current management). These results suggest that organs from donors with a history of recent marijuana use do not pose a significant new infection risk to recipients early after transplantation. ”
Current guidance regarding cannabis use and organ donation is inconsistent. recent reviews By a student fellow at the Petrie Fromm Center at Harvard Law School. The U.S. Organ Procurement Network says it leaves the decision on transplant eligibility up to each transplant center, but in fact many marijuana users are deemed ineligible.
“Many transplant centers are prohibiting cannabis users from undergoing solid organ transplants due to concerns about interactions between cannabis and the immunosuppressive drugs used in transplants, noncompliance with treatment, fungal infections, and neuropsychiatric effects. ” says the review.
But the latest study is one of a growing number of studies arguing against that policy. “Large studies are needed to verify these findings, but these studies suggest that medical cannabis use should not be an absolute contraindication to solid organ transplantation.” says the Harvard University Post. “Studies also suggest that THC, a component of cannabis, may actually help prevent transplant rejection.”
When it comes to actually identifying recent cannabis use, at least two recent developments hope to allow researchers to test subjects more accurately. Researchers supporting a federally funded study recently developed a new procedure that increases the selectivity of common forensic testing methods, improving the detection of delta-9 THC and its metabolites in blood. announced that it had.
The federal government also funded another recently published study that identified a promising new method for testing for recent cannabis use. The study, which was partially funded by the National Institute on Drug Abuse (NIDA), found that a more accurate test method than currently used is to analyze the molar metabolite ratio of THC and THC-COOH in the blood. It turned out to be.
The study is part of a growing call for more accurate and reliable ways to measure recent marijuana use and impairment, often related to driving, as more jurisdictions legalize marijuana. be.
Federally funded study strengthens marijuana screening procedures to detect THC in blood
Photo by Mike Latimer.
