Chronic opioid use and clinical outcomes in lung transplant recipients: A single‐center cohort study

Introduction Chronic opioid use is common after organ transplantation, and has been associated with poor outcomes in transplantation of abdominal organs. However, little is known about possible influences of chronic opioid use on outcomes of lung transplantation (LTx). Objectives We assessed whether...

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Bibliographic Details
Published in:The clinical respiratory journal 2018-09, Vol.12 (9), p.2446-2453
Main Authors: Drees, David, Tumin, Dmitry, Miller, Rebecca, Kirkby, Stephen, Bhalla, Tarun, Tobias, Joseph D., Hayes, Don
Format: Article
Language:English
Subjects:
Adolescent
Adult
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Analgesics, Opioid - therapeutic use
chronic pain
Chronic Pain - drug therapy
Clinical outcomes
Cohort analysis
Female
Forced Expiratory Volume - physiology
Graft Rejection - epidemiology
Health risk assessment
Hospitalization - statistics & numerical data
Humans
lung transplant
Lung Transplantation - mortality
Lung Transplantation - statistics & numerical data
Lungs
Male
Middle Aged
Narcotics
opioid
pediatric
Respiratory Function Tests - methods
Retrospective Studies
Risk Factors
Survival Rate
Transplant Recipients - statistics & numerical data
Transplants & implants
Young Adult
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Summary:Introduction Chronic opioid use is common after organ transplantation, and has been associated with poor outcomes in transplantation of abdominal organs. However, little is known about possible influences of chronic opioid use on outcomes of lung transplantation (LTx). Objectives We assessed whether long‐term chronic opioid use influenced clinical outcomes among LTx recipients at our program. Methods We retrospectively evaluated chronic opioid use among bilateral LTx recipients ages 12 and older followed at our institution 1‐5 years post‐transplant. Chronic opioid use was defined as ≥3 months of consecutive prescribed use. Outcomes included survival, hospitalization, emergency department and urgent care visits, forced expiratory volume in one second (FEV1), and allograft rejection. Results Twenty‐one patients ages 15‐50 years met inclusion criteria. On multivariable analysis, initiation of chronic opioid use was followed by increased mortality hazard (hazard ratio=7.1; 95% confidence interval [CI]: 1.1, 45.0, P = 0.037) and decreased FEV1 (‐16%; 95% CI: ‐24%, ‐7%; P 
ISSN:1752-6981
1752-699X
DOI:10.1111/crj.12948