Session Time: 4:00pm-5:30pm
Presentation Time: 4:24pm-4:36pm
Location: Room 118-AB
Background: Associations of narcotic use before kidney transplantation with post-transplant clinical outcomes are not well described.
Methods: We performed a retrospective analysis of linked national registry and pharmacy fill records in the United States to follow 16,322 kidney transplant recipients, of whom 4624 had evidence of a narcotic prescription filled in the year prior to transplantation. Opioid analgesic fills were normalized to morphine equivalents (ME) and expressed as mg/kg exposures (the 25th, 50th, and 74th percentiles of annual ME were 1.8, 5.5, and 23.7 mg/kg, respectively). We assessed the adjusted associations of pre-transplant ME level with post-transplant clinical outcomes.
Results: The incidence of complications among those with high-level pre-transplant ME exposure compared to no use at three-years post-transplant included: ventricular arrhythmias, 1.1% vs. 0.2% (p<0.001); cardiac arrest, 4.7% vs. 2.7% (p<0.05); hypotension, 14% vs. 8% (p<0.0001); hypercapnia, 1.6% vs. 0.9% (p<0.05); mental status changes, 5.3% vs. 2.7% (p<0.001); accidents, 0.9% vs. 0.3% (p<0.05); and non-compliance, 3.5% vs. 2.3% (p<0.05). Significant differences persisted after adjustment for baseline recipient, donor and transplant factors, and when analyzed separately by donor type.
Conclusion: Although associations may reflect underlying conditions or behaviors, high levels of prescription narcotic use before kidney transplantation predict increased risk of clinical complications after transplantation.
To cite this abstract in AMA style:Lam N, Schnitzler M, Tuttle-Newhall J, Xiao H, Axelrod D, Brennan D, Dharnidharka V, Nazzal M, Lentine K. Associations of Pre-Transplant Prescription Narcotic Use With Clinical Complications After Kidney Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/associations-of-pre-transplant-prescription-narcotic-use-with-clinical-complications-after-kidney-transplantation/. Accessed May 8, 2021.
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