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Journal article
Prescription opioid use before and after heart transplant: Associations with posttransplant outcomes
American journal of transplantation, v 19(12), pp 3405-3414
Dec 2019
PMID: 31397964
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Impacts of the prescription opioid epidemic have not yet been examined in the context of heart transplantation. We examined a novel database in which national U.S. transplant registry records were linked to a large pharmaceutical claims warehouse (2007-2016) to characterize prescription opioid use before and after heart transplant, and associations (adjusted hazard ratio, (95%) (LCL)aHR(95%) (UCL)) with death and graft loss. Among 13 958 eligible patients, 40% filled opioids in the year before transplant. Use was more common among recipients who were female, white, or unemployed, or who underwent transplant in more recent years. Of those with the highest level of pretransplant opioid use, 71% continued opioid use posttransplant. Pretransplant use had graded associations with 1-year posttransplant outcomes; compared with no use, the highest-level use (>1000 mg morphine equivalents) predicted 33% increased risk of death (aHR (1.10)1.33(1.61)) in the year after transplant. Risk relationships with opioid use in the first year posttransplant were stronger, with highest level use predicting 70% higher mortality (aHR (1.46)1.70(1.98)) over the subsequent 4 years (from >1 to 5 years posttransplant). While associations may, in part, reflect underlying conditions or behaviors, opioid use history is relevant in assessing and providing care to transplant candidates and recipients.
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Details
- Title
- Prescription opioid use before and after heart transplant: Associations with posttransplant outcomes
- Creators
- Krista L. Lentine - St Louis Univ, Sch Med, Ctr Abdominal Transplantat, St Louis, MO 63103 USAKevin S. Shah - Cedars-Sinai Medical CenterJon A. Kobashigawa - Cedars-Sinai Medical CenterHuiling Xiao - Saint Louis UniversityZidong Zhang - Saint Louis UniversityDavid A. Axelrod - University of IowaNgan N. Lam - University of AlbertaDorry L. Segev - Johns Hopkins UniversityMara Ann McAdams-DeMarco - Johns Hopkins UniversityHenry Randall - Saint Louis UniversityGregory P. Hess - Drexel UniversityHui Yuan - Saint Louis UniversityLuke S. Vest - Saint Louis UniversityBertram L. Kasiske - Hennepin County Medical CenterMark A. Schnitzler - Saint Louis University
- Publication Details
- American journal of transplantation, v 19(12), pp 3405-3414
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- R01DK120518 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) KRESCENT New Investigator Award; Canadian Institutes of Health Research (CIHR) R01DK120518 / National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) HHSH250201000018C / Hennepin Healthcare Research Institute
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000486287900001
- Scopus ID
- 2-s2.0-85073770663
- Other Identifier
- 991021860809304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Surgery
- Transplantation