History of Chronic Opioid Usage and Early Post Transplant Outcomes
Internal Medicine, University of Michigan, Ann Arbor, MI
Presbyterian Kidney Transplant Center, Albuquerque, NM
Meeting: 2013 American Transplant Congress
Abstract number: A808
Introduction: Chronic opioids usage (COU) is highly prevalent among ESRD patients and can be associated with adverse clinic outcomes. We studied the relationship between a positive history of COU and delayed graft function post kidney transplantation.
Materials and Methods: Between January 2004 and December 2008, all ESRD patients undergoing deceased donor kidney transplantation at our institution were included. A history of COU prior to transplantation was ascertained through chart reviewing. Delayed graft function was defined as the need for dialysis treatment within the first week post transplantation. Other pertinent demographic and baseline characteristics were obtained as well. Univariate and multivariate statistical analysis were utilized.
Results: Of these 533 patients, 61 (11.4%) had a positive history of chronic opioids usage, defined as continued and regular use for at least three months, while awaiting kidney transplantation. Patients with such history exhibited many unfavorable baseline characteristics such as high comorbidity scores, high prevalence of psychiatric history, physical pain and the need of pain medications, more positive history of alcohol and/or illicit drug usage.
| COU yes, n=61 | COU no, n=472 | p | |
| Age, mean (sd) | 52.9 (9.8) | 50.7 (12.9) | 0.126 |
| Gender, male (%) | 36 (59) | 295 (62.5) | 0.598 |
| African American, n (%) | 20 (32.8) | 116 (24.6) | 0.166 |
| BMI, mean (sd) | 27.7 (6) | 28.7 (5.7) | 0.217 |
| ECD/DCD, n (%) | 17 (27.9) | 123 (26.1) | 0.763 |
| Cold ischemia time, hours (sd) | 13.3 (5.3) | 143 (30.3) | 0.772 |
| Comorbidity scores, mean (sd) | 4.3 (1.8) | 3.8 (1.7) | 0.033 |
| Presence of pain, n (%) | 48 (78.7) | 192 (40.7) | 0.000 |
| Use of non-opioid pain medications, n (%) | 18 (29.5) | 53 (11.2) | 0.000 |
| History of ETOH abuse, n (%) | 13 (21.3) | 54 (11.4) | 0.029 |
| History of illicit drug abuse, n (%) | 15 (24.6) | 58 (12.3) | 0.009 |
| History of psychiatric illness, n (%) | 30 (49.2) | 138 (29.2) | 0.002 |
| Working, n (%) | 11 (18) | 161 (34.1) | 0.011 |
Post-transplantation, 16 (26.2%) and 68 (14.4%) of patients with and without a positive history of COU experienced delayed graft function, p=0.017. COU was independently associated with more than twice increased risk for delayed graft function (AOR 2.32, 95% CI 1.18, 4.56, p=0.015).
Conclusion: Patients with a positive of COU history prior to transplantation were at increased risk for delayed graft function. A better understanding of such negative association may provide the opportunity for therapeutic interventions.
To cite this abstract in AMA style:
Kulshrestha S, Barrantes F, Kommareddi M, Samaniego M, Luan F. History of Chronic Opioid Usage and Early Post Transplant Outcomes [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/history-of-chronic-opioid-usage-and-early-post-transplant-outcomes/. Accessed November 23, 2024.« Back to 2013 American Transplant Congress