Marijuana use should not preclude consideration for kidney transplantation

Clin Transplant. 2019 Oct;33(10):e13706. doi: 10.1111/ctr.13706. Epub 2019 Oct 16.


Transplant eligibility for tobacco and/or marijuana using candidates varies among transplant centers. This study compared the impact of marijuana use and tobacco use on kidney transplant recipient outcomes. Kidney transplant recipients at a single center from 2001 to 2015 were reviewed for outcomes of all-cause graft loss, infection, biopsy-proven acute rejection, and estimated glomerular filtration rate between four groups: marijuana-only users, marijuana and tobacco users, tobacco-only users, and nonusers. The cohort (N = 919) included 48 (5.2%) marijuana users, 45 (4.8%) marijuana and tobacco users, 136 (14.7%) tobacco users, and 75% nonusers. Smoking status was not significantly associated with acute rejection, estimated glomerular filtration rate or pneumonia within one-year post-transplant in an adjusted model. Compared to nonuse, marijuana and tobacco use and tobacco-only use was significantly associated with increased risk of graft loss (aHR 1.68, P = .034 and 1.52, P = .006, respectively). Patients with isolated marijuana use had similar overall graft survival compared to nonusers (aHR 1.00, P = .994). Marijuana use should not be an absolute contraindication to kidney transplant.

Keywords: alcoholism and substance abuse; graft survival; kidney (allograft) function/dysfunction.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / etiology
  • Graft Rejection / mortality*
  • Graft Rejection / pathology
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Function Tests
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / mortality*
  • Male
  • Marijuana Use / adverse effects*
  • Middle Aged
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality*
  • Postoperative Complications / pathology
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tobacco Smoking / adverse effects*