VIDEO: Opioid use pre vs. post liver transplant largely remains steady

SAN FRANCISCO — In this exclusive video perspective from The Liver Meeting 2018, Monica Konerman, MD, director of the Michigan Medicine NAFLD Clinic, discusses the varying prevalence of opioid use among liver transplant candidates before and after transplantation.

“We know that pain is a very common chronic symptom among individuals who are being evaluated for live transplantation, but we don’t have very good data on what is the prevalence of use among patients who are listed for transplant and how that use changes after they undergo liver transplantation,” Konerman told Healio Gastroenterology and Liver Disease. “By and large, the vast majority of people did not change their pattern of use ... if they were chronic users before transplant, they tended to continue to be chronic users after transplant.”

The study comprised national data on 1,257 adults who underwent liver transplantation between 2009 and 2015. Konerman and colleagues assessed opioid use 1 year prior to and 1 year after transplant.

Before liver transplantation, 45% of patients filled one or more opioid prescription. Of those, 35% had intermittent use and 10% had chronic use. At 1-year posttransplant, the prevalence of any opioid prescriptions reduced from 61% in the first 2 months to 21% between 10 months and 1 year.

The researchers observed new persistent use in 9% of posttransplant patients. Among opioid-naive transplant patients, 4.2% became chronic users posttransplant.

Overall, opioid use decreased in 8.5%, was maintained in 58.8%, and increased in 32.7% of liver transplant recipients. Among individuals with intermittent use prior to transplant, 12.5% increased to chronic use following transplant. Among those with baseline chronic use, 73% maintained chronic opioid use following transplant.

“We were also really interested in knowing the type of liver disease or other kind of clinical variables impact change in use pre vs. posttransplant,” Konerman said. “The only thing that stood out was that individuals who were transplanted primarily for liver cancer tended to have the lowest rates of use of opioids after transplant. So, it seems like the reason patients are being transplanted does seem to have an impact on what they do in terms of needs of opioids following transplant.” – by Talitha Bennett

Reference:

Konerman MA, et al. Abstract 1205. Presented at: The Liver Meeting 2018; Nov. 9-13, 2018; San Francisco.

Disclosure: Konerman reports no relevant financial disclosures.