Pre-Transplant Cannabis Use Linked to Higher Immediate Opioid Needs But No Worse Liver Transplant Outcomes
Cannabis users needed more opioids in the first 48 hours after liver transplant, but this did not translate to worse outcomes for hospital stay, readmission, or mortality.
Quick Facts
What This Study Found
Among 4,236 patients, cannabis users required significantly more opioids in the 48 hours after transplant (p=0.04). No significant differences in opioid use beyond 48 hours, discharge opioid prescriptions, hospital or ICU length of stay, 90-day readmission, or 90-day mortality.
Key Numbers
4,236 patients. Higher opioids at 48 hours (p=0.04). No difference at 72 hours (p=0.07) or 7 days (p=0.33). No difference in LOS (p=0.69), ICU LOS (p=0.94), readmission (p=0.66), or mortality (p=0.96).
How They Did This
Retrospective cohort of 4,236 patients evaluated for liver transplant (January 2013-July 2023). Cannabis use defined as positive urine toxicology within 90 days. Multivariable regression compared outcomes.
Why This Research Matters
Some transplant centers still consider cannabis use a barrier to eligibility. This data supports growing evidence that pre-transplant cannabis use does not worsen outcomes.
The Bigger Picture
Cannabis use has historically been used to deny organ transplant listing. This study challenges those policies by showing no association with worse outcomes.
What This Study Doesn't Tell Us
Single-center retrospective. Cannabis defined by single urine test. No data on type or frequency of use.
Questions This Raises
- ?Should transplant centers update policies?
- ?Why do cannabis users need more opioids immediately after surgery?
- ?Does the type of cannabis use matter for outcomes?
Trust & Context
- Key Stat:
- No difference in 90-day readmission or mortality
- Evidence Grade:
- Moderate: large retrospective cohort with multivariable adjustment, but single-center and crude exposure measure.
- Study Age:
- Published in 2025, with data from 2013-2023.
- Original Title:
- Cannabis and liver transplant in the era of legalization: Effects of pretransplant cannabis use on postoperative opioid use and transplant outcomes.
- Published In:
- Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 31(11), 1398-1410 (2025)
- Authors:
- Runge, Ava, Loeb, Becca, Shui, Amy M, Fenton, Cynthia, Lai, Jennifer, Rubin, Jessica
- Database ID:
- RTHC-07533
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Does cannabis use affect liver transplant outcomes?
This study found cannabis users needed slightly more pain medication in the first 48 hours, but there was no difference in hospital stay, readmission, or survival.
Can cannabis users receive organ transplants?
Policies vary, but this study adds to growing evidence that pre-transplant cannabis use does not worsen outcomes.
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Cite This Study
https://rethinkthc.com/research/RTHC-07533APA
Runge, Ava; Loeb, Becca; Shui, Amy M; Fenton, Cynthia; Lai, Jennifer; Rubin, Jessica. (2025). Cannabis and liver transplant in the era of legalization: Effects of pretransplant cannabis use on postoperative opioid use and transplant outcomes.. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 31(11), 1398-1410. https://doi.org/10.1097/LVT.0000000000000585
MLA
Runge, Ava, et al. "Cannabis and liver transplant in the era of legalization: Effects of pretransplant cannabis use on postoperative opioid use and transplant outcomes.." Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2025. https://doi.org/10.1097/LVT.0000000000000585
RethinkTHC
RethinkTHC Research Database. "Cannabis and liver transplant in the era of legalization: Ef..." RTHC-07533. Retrieved from https://rethinkthc.com/research/runge-2025-cannabis-and-liver-transplant
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.