*Purpose: In light of the current legislative changes in Canada, and the variable approach to marijuana use in the United States, it is important to understand the potential impact of marijuana use on the access to kidney transplant (KT). Therefore, we studied the frequency of self-reported marijuana use, its socio-demographic correlates, as well as its association with access to KT among patients referred for kidney transplantation.

*Methods: Data from patients referred for KT in our institution between January 1, 2003 and December 31, 2012, who completed social work assessment, were analyzed. Patients for whom a complete social work assessment note was not available or were referred for multiorgantransplant, were excluded. Psychosocial characteristics (age, sex, marital status, employment, ethnicity, socio-economic status), history of mental health concerns, and non-adherence were abstracted from the pre-transplant notes. Predictors of self-reported marijuana use were examined using a multivariable logistic regression. The association between self-reported marijuana use and time from referral to being cleared for KT and receipt of a KT were examined using Cox proportional hazards models.

*Results: The mean (SD) age of the1,769 ESKD patients in the study cohort was 49 +14 years; 60% were male, 54% were White, and 43% were unemployed. A total of 189 patients (10.6%) reported current (62 patients, 3.5%) or historic (127 patients, 7.1%) marijuana use at the time of transplant assessment. Cannabis users were more frequently male (72.3% vs 59.2%, p=0.002), had history of mental health conditions (35% vs 23%, p=0.003), and a history of non-adherence (35% vs 16%, p<0.001) when compared to rest of the cohort. In a multivariable logistic regression model, independent predictors of self-reported marijuana use (defined as current or historic) were male sex (OR 2.02 [95%CI: 1.31, 3.11]) and a history of non-adherence (OR 1.99 [95%CI: 1.29, 3.07]). Self-reported marijuana use was not associated with a lower relative hazard of being cleared for KT (HR 0.90 [95%CI: 0.70, 1.10]) or receiving a KT (HR 0.94 [95%CI: 0.72, 1.24]).

*Conclusions: Self-reported marijuana use was not associated with a reduced access to the waiting list or receiving a KT in our single-center cohort study. An analysis of prospectively collected data across multiple centers should be the focus of future research in order to confirm our findings and enhance their generalizability.

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