Currently, transplant centers vary in screening practices for marijuana use and requirements for abstinence before kidney transplantation

We examined billing claims and linked SRTR data for 52,689 Medicare-insured kidney transplant recipients to identify diagnoses of cannabis dependence or abuse (CDOA, International Classification of Diseases-9 304.3, 305.2) in the year before and after transplant. Associations of CDOA with post-transplant death and graft failure (adjusted hazard ratio, 95% _LCL aHR 95% _UCL) were quantified by multivariate Cox regression including adjustment for recipient, donor, and transplant factors, and propensity for CDOA.

CDOA diagnoses were uncommon, found in 0.5% and 0.3% in the year before and after transplant, respectively. Diagnoses of CDOA before and after transplant declined with older recipient age, and was more common in men, African Americans, those with less than college education<ins cite="mailto:Ngan%20Lam" datetime="2017-11-14T20:29">,</ins> and unemployed. After multivariate and propensity adjustment, CDOA in the year before transplant was not associated with death or graft survival in the year after transplant. However, CDOA in the first year post-transplant was associated with three-times the risk of death-censored graft failure (aHR _1.722.93_4.99) and 2.5-times the risk of all-cause graft loss (aHR _1.592.57_4.17) in the subsequent year.

Diagnoses of CDOA are uncommon among kidney transplant recipients, and likely reflect a select subgroup of cannabis users who reach clinical attention. While associations likely in part reflect associated conditions or behaviors, CDOA in the year after transplant appears to have prognostic importance for subsequent allograft function.

CITATION INFORMATION: Lentine K., Alhamad T., Lam N., Naik A., Koraishy F., Randall H., Segev D., Dharnidharka V., Brennan D., Kasiske B., Ouseph R., Schnitzler M. Cannabis Dependence or Abuse before and after Kidney Transplantation: Implications for Post-Transplant Outcomes Am J Transplant. 2017;17 (suppl 3).

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