Should medical cannabis use disqualify someone from receiving a kidney transplant? | Research

The takeaway

A 20-year-old woman was initially denied a renal transplant listing due to her medical cannabis use, raising ethical questions about using legal medical treatments as barriers to life-saving procedures.

Transplant teams, medical cannabis patients awaiting transplant, and medical ethicists.

Patient denied transplant listing for using legal medical cannabis

What the researchers found

A 20-year-old woman recommended for renal transplant was originally denied active listing because of her medical cannabis use. The review found that many healthcare providers are uninformed or misinformed about the actual risks of cannabis in immunocompromised patients.

Why it matters

As medical cannabis becomes legal in more states, transplant teams will increasingly face this dilemma. Denying life-saving treatment based on a legal medical therapy raises serious ethical concerns.

The numbers in context

Medical cannabis is legal in over half of US states. 1 patient initially denied transplant listing. Few professional organizations provide guidance on this issue.

How the study worked

Ethical case study with literature review examining perceived versus actual risks of cannabis use in transplant patients and the ethics of denying transplants based on medical cannabis use.

What this study cannot tell us

Single case report. The actual transplant outcomes for cannabis users versus non-users remain poorly studied. The ethics discussion, while important, is opinion-based.

How to read the evidence

Preliminary: single case report with ethical analysis.

When this study was published

Published in 2019.

The bigger picture

Organ allocation decisions have enormous consequences. If medical cannabis use becomes a de facto disqualifier, patients in legal states may be punished for following their physicians' recommendations.

Questions still open

Does medical cannabis actually worsen transplant outcomes? Should transplant teams differentiate between medical and recreational cannabis use? Could standardized guidelines prevent inconsistent decisions?

Common questions

Do transplant centers routinely deny cannabis users?

Practices vary widely. Many transplant programs still consider any cannabis use a relative or absolute contraindication, even in states where it is legally prescribed.

Does cannabis actually harm transplant outcomes?

The evidence is limited. The review found that many perceived risks are not well-supported by data, and healthcare providers often rely on outdated or inaccurate assumptions about cannabis risks in immunocompromised patients.

Read the original research

Denying renal transplantation to an adolescent medical cannabis user: An ethical case study.

Pediatric transplantation, 23(5), e13467

View on PubMed ↗Publisher’s paper ↗

Citation

Ryan, Jennie E; Noeder, Maia; Burke, Christine; Stubblefield, Samuel C; Sulieman, Salwa; Miller, Elissa G. (2019). Denying renal transplantation to an adolescent medical cannabis user: An ethical case study.. Pediatric transplantation, 23(5), e13467. https://doi.org/10.1111/petr.13467