Outcomes Associated with Opioid Use in Cardiothoracic Transplant Recipients

Abstract

Purpose Several recent studies have linked opioid use to increased rates of hospital readmissions, graft loss, and death in solid organ transplant recipients. However, there is limited data in cardiothoracic transplant recipients (CTRs). The aim of this study was to assess the impact of opioid use in CTRs. Methods This was a single center, retrospective study of adult CTRs transplanted from 10/1/2015-10/1/2016. Patients were excluded if graft loss or death occurred during the index hospitalization. Opioid use was assessed both 1-year prior to and 1-year after transplantation, excluding hospitalization. Data was collected via EMR that incorporated insurance claims of opioid fill history. The primary endpoint was the incidence of the composite of BPAR, graft loss or death within 1 year, and 30-day hospital readmission. Results A total of 84 CTRs were transplanted during the study period, with 79 patients meeting the inclusion criteria. There was no difference in the incidence of the primary outcome in patients who used opioids compared to non-opioid users (47.7% vs 60%, p=0.278), or in the individual components of the primary outcomes. Pre-transplant opioid users had no difference in outcomes compared to patients without pre-transplant opioid use (44.4% vs 55.7%, p=0.398). Post-transplant opioid use was common (48.1%), however, also did not impact the primary outcome (50% vs 56.1%, p=0.587). Further analysis found no differences in the duration of opioid use, the average daily amount of opioid use, or the type of transplant. Conclusion Contrary to previous studies, opioid use had no significant impact on transplant-related outcomes in CTRs.