@article{4c07ecf88a884cffac3fc07c85754e93,
title = "Prescription opioid use before and after kidney transplant: Implications for posttransplant outcomes",
abstract = "Evolving literature suggests that the epidemic of prescription opioid use affects the transplant population. We examined a novel database wherein national U.S. transplant registry records were linked to a large pharmaceutical claims warehouse (2007-2015) to characterize prescription opioid use before and after kidney transplant, and associations (adjusted hazard ratio, 95% LCLaHR95% UCL) with death and graft loss. Among 75 430 eligible patients, 43.1% filled opioids in the year before transplant. Use was more common among recipients who were women, white, unemployed, publicly insured, and with longer pretransplant dialysis. Of those with the highest level of pretransplant opioid use, 60% continued high-level use posttransplant. Pretransplant opioid use had graded associations with one-year posttransplant outcomes; the highest-level use predicted 46% increased risk of death (aHR 1.281.461.66) and 28% increased risk of all-cause graft failure (aHR 1.171.281.41). Effects of high-level opioid use in the first year after transplant were stronger, predicting twice the risk of death (aHR 1.932.242.60) and 68% higher all-cause graft failure risk (aHR 1.501.681.89) over the subsequent year; increased risk persisted over five years. While associations may, in part, reflect underlying conditions or behaviors, opioid use history is relevant in assessing and providing care to transplant candidates and recipients.",
keywords = "Scientific Registry for Transplant Recipients (SRTR), clinical research/practice, epidemiology, kidney transplantation/nephrology",
author = "Lentine, {K. L.} and Lam, {N. N.} and Naik, {A. S.} and Axelrod, {D. A.} and Z. Zhang and Dharnidharka, {V. R.} and Hess, {G. P.} and Segev, {D. L.} and R. Ouseph and H. Randall and T. Alhamad and R. Devraj and R. Gadi and Kasiske, {B. L.} and Brennan, {D. C.} and Schnitzler, {M. A.}",
note = "Funding Information: This work was conducted under the auspices of the Minneapolis Medical Research Foundation (MMRF), contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201000018C (U.S. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a U.S. Government–sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the U.S. Government. This work was supported by a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01-DK096008. NNL was supported by a KRESCENT New Investigator Award. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. Funding Information: This work was conducted under the auspices of the Minneapolis Medical Research Foundation (MMRF), contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201000018C (U.S. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a U.S. Government?sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the U.S. Government. This work was supported by a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01-DK096008. NNL was supported by a KRESCENT New Investigator Award. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. Publisher Copyright: {\textcopyright} 2018 The American Society of Transplantation and the American Society of Transplant Surgeons",
year = "2018",
month = dec,
doi = "10.1111/ajt.14714",
language = "English (US)",
volume = "18",
pages = "2987--2999",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley",
number = "12",
}