Opiate Use Trends after Liver Transplantation and the Factors Associated with Post-Transplant Opiate Dependence

M. Siddiqui,¹ R. Kaur,¹ S. Dhoop,² N. Sulejmani,¹ R. Salgia.¹

¹Henry Ford Hospital, Detroit, MI
²Wayne State University SOM, Detroit, MI.

Meeting: 2018 American Transplant Congress

Abstract number: 69

Keywords: Liver transplantation, Pain

Session Information

Session Name: Concurrent Session: Liver: Recipient Selection

Session Type: Concurrent Session

Date: Sunday, June 3, 2018

Session Time: 2:30pm-4:00pm

Presentation Time: 2:42pm-2:54pm

Location: Room 6C

Aims

Our study aims to determine predictive factors leading to post-liver transplant (LT) opioid dependence.

Methods

A retrospective chart review was conducted including LT recipients from July 2013-June 2016. Patients were excluded if they had a history of other major surgery or trauma. A linear logistic regression was performed to predict opioid use in terms of oral Morphine equivalents, fitting separate models for time from LT. The change over time in opiate use was also tested using a McNemar's test.

Results

The results of the multivariate analysis revealed that opioid use pre-LT was associated with increased risk of opiate use post-LT, OR ranging from 2.08-3.57 between 3 months to 2 years post-LT. The concurrent use of psychotropic medications (for anxiety, depression or bipolar disorder) increased the likelihood of opiate use at 1 and 2 years post-LT. Patients were at a lower risk of developing post-LT opiate dependence if they were female or had a strong support system. (Table 1). McNemar's test revealed that the prevalence of ongoing opiate use did decrease from 85.6% at 1 month post-LT to 13.3% at 2 years post-LT.

Time from LT	Variable	OR (95% CI)	p-Value
3 months	Pre-LT Opiate use	2.51 (1.41, 4.47)	0.002
	Support system	0.19 (0.06, 0.58)	0.004
6 months	Pre-LT Opiate use	3.57 (1.98, 6.46)	0.001
	Support system	0.33 (0.13, 0.87)	0.025
	Alcohol	1.21 (1.05, 1.41)	0.010
1 year	Pre-LT Opiate use	2.08 (1.31, 3.82)	0.02
	Female	053 (0.29, 0.98)	0.042
	Pre-LT psych medications	2.09 (1.17, 3.74)	0.013
2 years	Pre-LT Opiate use	2.16 (0.99, 4.67)	0.052
	Pre-LT psych medications	2.86 (1.35, 6.05)	0.006

Conclusion

This study reveals factors associated with increased post-LT opiate dependence including pre-LT opiate use, concurrent use of psychotropic medications and a history of prior alcohol dependence. Importantly a strong support system is associated with lower risk for post-LT opiate dependence. Ongoing efforts to recognize patients at high risk for opiate dependence allow the transplant community to help curb the reliance on opioid analgesics and to seek out alternative methods of pain management.

CITATION INFORMATION: Siddiqui M., Kaur R., Dhoop S., Sulejmani N., Salgia R. Opiate Use Trends after Liver Transplantation and the Factors Associated with Post-Transplant Opiate Dependence Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Siddiqui M, Kaur R, Dhoop S, Sulejmani N, Salgia R. Opiate Use Trends after Liver Transplantation and the Factors Associated with Post-Transplant Opiate Dependence [abstract]. https://atcmeetingabstracts.com/abstract/opiate-use-trends-after-liver-transplantation-and-the-factors-associated-with-post-transplant-opiate-dependence/. Accessed November 21, 2024.

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