Scientists Investigate: Does It Makes Sense To Deny Liver Transplants To Cannabis Users?

Although the CDC estimates that 48.2 million Americans (18 percent of the population) used cannabis in 2019, at least eight states have passed laws prohibiting the denial of a transplant solely on the basis of marijuana use.
Due to the lack of consensus among medical experts about cannabis use and organ transplants - with excuses ranging from legal status to fears the drug could increase fungal infections or cause the body to reject the new organ - cannabis users are regularly denied transplants.

Liver Transplant & Marijuana Use: What Do Researchers Say?

However, to help understand whether these kinds of transplant restrictions have any medical merit, researchers at the University of Alabama at Birmingham compared the survival rates of liver transplant recipients based on their marijuana use.

The study enrolled 111 patients, of whom 75 percent were men suffering from different types of liver diseases that required a transplant, including heavy alcohol use, viruses such as hepatitis C, and fatty liver disease. Between 2016 and 2021, participants tested positive for cannabis using a urine drug screen during transplant evaluations. In addition, the study included another 100 non-marijuana users who had received liver transplants.

Researchers noted that only "32 cannabis-using patients out of the 111 received a liver transplant. The remaining 79 were denied for varying reasons, including insurance or financial issues, with 41 explicitly denied for "continued marijuana use" as one of several non-compliance problems. Only 11 were denied solely for using cannabis," reads the study published in the American Journal of the Medical Sciences.

The researchers focused particularly on fungal infections, which, being invasive, are some of the most serious complications of liver transplants, especially a fungus called Aspergillus, which can also grow on cannabis plants.

As Salon reported, researchers feared that ingesting an Aspergillus-contaminated cannabis product would complicate the transplant and lead to failure or death. However, "there was no significant difference in overall mortality between marijuana users and non-users" and using cannabis prior to transplant "was not associated with post-transplant infections or readmissions up to one-year post-surgery,” the authors reported.

In addition, a 2021 study in the journal Clinical Transplantation examined waiting list outcomes for 630 cannabis-using patients at the University of Michigan and 2,060 who reported no cannabis use. However, those marijuana users were 33 percent less likely to appear on the list and experienced longer wait times, which the authors attribute to possible stigma.

Of the 132 cannabis-using patients included, 83 received a transplant, compared to 306 patients in the control group. "Patient survival and graft rates, which is the organism that accepts the transplant, were similar in both groups," the authors concluded.

However, some investigation has shown that cannabis use could actually be helpful for transplants. Cannabidiol, or CBD, one of the main drugs in marijuana, has liver-protective benefits, although much of this research is done on rats or mice, rather than humans.

Health First: Let’s Keep Informed And Educated About Cannabis Benefits

Given the lack of sufficient evidence and data that cannabis use can harm liver transplants, the fatal risks faced by people who need organ transplants are increasing. It's time to put aside the stigma around cannabis users, including memory loss issues or the myth that using marijuana makes you lazy, but above all to stop denying patients medical care based on their marijuana use.

In July, Tilray Brands, Inc. TLRY, a Canada-based cannabis company, through its subsidiary Tilray Medical launched an educational platform called WeCare-MedicalCannabis to provide education about the benefits of medical cannabis to consumers and medical practitioners.

Photo: Courtesy Of CDC On Unsplash