Introduction: As Marijuana use is gaining social acceptance, many transplant centers face questions regarding candidacy of users for kidney transplantation. Currently its impact on post-transplantation outcomes remains unknown.

Methods: We report a single center retrospective cohort study of all patients undergoing kidney transplantation during 2004 through 2008. Patients were followed until allograft failure, death or December 2012, whichever was earlier. As part of their evaluation process consumption of substances of abuse including Marijuana was assessed. Data was collected from our electronic health record system. Differences between characteristics were measured using unpaired t test for continuous variables and chi square test for categorical variables. Univariate logistic regression models were used to identify independent predictors of marijuana consumption. Death censored allograft failure was assessed by the Kaplan Meier estimate. The log rank test was used to assess equality of survivor functions.

Results: Overall, 139 of 1064 patients (13.06 %) qualified as marijuana users. Marijuana users were significantly (p<0.05) more likely to be younger (45.3 years vs. 50 years), male (OR=2.89), have hepatitis C (OR=2), more likely to have used alcohol (OR =3.03), be current smokers (OR = 3.22), used other illegal drugs (OR=27.5) or receiving psychiatric medications (OR 1.6, P=0.01). No difference was found in time to listing for the transplant, length of stay, hospitalizations or BPAR at one year. No association was found between marijuana consumption and pain. Death censored graft survival (log rank; p=0.36) and all-cause mortality (log-rank: P=0.22) was similar in both groups.

Conclusions: Marijuana users are not exposed to additional risk of morbidity or mortality with kidney transplantation. Additional studies are warranted to confirm this observation.

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