*Purpose: The impact of early narcotic administration on intestinal transplant patients is not well understood, with current practice suggesting the avoidance of narcotics among transplant patients. We examine patient survival and early intestinal rejection among intestinal transplant patients who were administered narcotic pain medication post-transplant surgery at a single urban medical center.

*Methods: A retrospective chart review was conducted for 26 intestinal transplant patients at a large urban medical center. The patients were separated into two groups: those who utilized narcotics up to six-months post-transplant, and those who did not. Trends in early intestinal rejection and patient survival were then noted among the two groups.

*Results: Twenty-six patients were transplanted after undergoing intestinal failure. Three patient charts were excluded due to medical charting discrepancies; 23 patient charts were utilized for analysis. 30% of these patients were prescribed narcotics at six-months or earlier post-transplant surgery. The average age of these patients was 49.4 years, with 71.5% being female. These patients were transplanted due to various secondary causes including Crohn’s disease, neuroendocrine carcinoma, and abdominal trauma. On the other hand, the average age of the non-narcotic group of patients was 51.6 years, with 62.5% being female. These patients underwent intestinal transplant for causes similar to the narcotics group, including Crohn’s disease, neuroendocrine carcinoma, gunshot wound, complications from ruptured appendices, and visceral myopathy. 85.7% and 71.4% of patients who had received narcotics after transplant were alive 1 year and 5 years post-transplant, respectively. On the other hand, 93.8% and 75.0% of patients who did not receive narcotics were alive 1 year and 5 years post-transplant, respectively. Of the patients who received narcotics, 28.6% of these patients also experienced acute intestinal rejection at 6-months or earlier post-transplant, whereas 43.8% of patients not receiving narcotics experienced acute intestinal rejection at 6-months or earlier post-transplant.

*Conclusions: Variations in 1-year survival can be noted amongst transplant patients who are receiving narcotics and who are not receiving narcotics, whereas variations in 5-year survival does not seem to be as significant between these two groups. It would be worthwhile to further investigate the impacts of narcotics on intestinal transplant patient morbidity and mortality through large, multi-center studies to better standardize patient care.

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