Double successful buprenorphine/naloxone induction to facilitate cardiac transplantation in an iatrogenically opiate-dependent patient

J Addict Med. 2012 Jun;6(2):177-8. doi: 10.1097/ADM.0b013e3182486e44.


Buprenorphine/naloxone is used for the treatment of opioid dependence. In the following case, a potential use for the medication combination is explored in the arena of transplant surgery. Psychiatry was consulted for a 29-year-old woman with iatrogenic opioid dependence after bilateral ventricular assist device placement for congenital cardiomyopathy. Her ejection fraction was less than 15% and she was considered a poor candidate for transplant due to drug-seeking behaviors. We transitioned her onto buprenorphine/naloxone to prevent abuse and control symptoms, qualifying her for cardiac transplant. After transplant, we coordinated care with cardiothoracic surgeons to restart buprenorphine/naloxone, and the patient has been stable for 8 months.

MeSH terms

  • Adult
  • Buprenorphine / administration & dosage*
  • Cardiomyopathies / congenital
  • Cardiomyopathies / surgery
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Heart Transplantation*
  • Heart-Assist Devices*
  • Humans
  • Iatrogenic Disease*
  • Naloxone / administration & dosage*
  • Narcotics / administration & dosage*
  • Narcotics / adverse effects*
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / etiology
  • Opioid-Related Disorders / rehabilitation*
  • Pain, Postoperative / drug therapy*
  • Substance Withdrawal Syndrome / diagnosis


  • Narcotics
  • Naloxone
  • Buprenorphine