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Narcotics users had decreased survival after liver transplantation

PHILADELPHIA — In the peri-liver transplant time period, narcotics users showed decreased long-term survival rates and increased rehospitalization rates compared with patients who were not narcotics users, according to data presented at the ACG Annual Scientific Meeting.

Researchers evaluated electronic charts of 276 patients who underwent primary liver transplant between 2008 and 2010. Narcotics use was measured pre-transplant and post-transplant to determine any effect drug use had on rates of rehospitalization and mortality after transplant. Approximately 63% of patients were male, 64.7% were white and 17% were African American.

Pre-transplant, 24% of patients were narcotic users; 21.3% of those were females and 30.3% were male. Six months after liver transplantation, 27.3% of all patients were narcotics users; of those 25.7% were white, 30.4% were African American and 29.8% were other races.

A higher 1-year survival rate was observed among the patients who were not narcotics users pre-transplant, as compared with patients who were narcotic users (90% vs. 86.4%). Three-year survival was also higher for patients who were not narcotic users pre-transplant compared with narcotic users pre-transplant (81.9% vs. 68.3%, P=.02).

Looking at those who used narcotics at 6 months post-transplant, the 1-year survival rate was higher for those who were not narcotics users compared with those who did use narcotics 6 months after transplant (97.4% vs. 91.7%, P=.04) with similar impact seen on 3-year survival rates (88% vs. 75%, P=.04).

Narcotics users had a greater moderate-severe rejection rate compared with non-narcotics users (15.2% vs. 6.2%; P=.02). Narcotics use pre-transplant was associated with a higher 30-day rehospitalization rate as compared with non-narcotics users (40.3% vs. 35.5%, P=.49).

“Chronic narcotic use in the peri-liver transplant period significantly decreased long-term patient survival, increases the rate of moderate-severe injection and is associated with increased rehospitalization rates,” the researchers wrote in the abstract. “Further study is needed to elucidate a potential dose effect to determine if there is a level of chronic narcotic use that may be considered safe surrounding liver transplantation.”

For more information:

Pirzadeh M. Abstract P259. Presented at: ACG Annual Scientific Meeting, Oct. 20-22, 2014; Philadelphia, PA.

Disclosure: Relevant financial disclosures were not provided by the researchers.