Introduction

There is a current shortage of kidneys available for transplantation. Based on United Network for Organ Sharing recommendations that exclude substance abusers from donation, many transplant institutions refuse live kidney donors who have a history of marijuana use; however, there is no evidence pertaining specifically to the donor or recipient outcomes. This is the first study to investigate the effect of marijuana use by live kidney donors upon outcomes in both donors and recipients.

Methods

A retrospective chart review for living kidney donors and their recipients between January 2000 and May 2016 was performed, stratifying patients based upon prior donor marijuana usage. Demographics and intra-operative variables were reported and compared for all groups. Outcomes compared included absolute and percent creatinine change and percent glomerular filtration rate (GFR) change in both donors and recipients, stratified by duration of marijuana usage. Baseline values for recipients were calculated based on their 1 week post-op creatinine values. Statistical analysis was performed using the t-test for numerical variables and the chi-square test for categorical variables with p<0.05 considered significant.

Results

Of total of 294 renal donor charts reviewed in this study,31 were marijuana using donors and 263 were non-marijuana using donors. There was no difference in donor preoperative, perioperative, or postoperative outcomes based upon marijuana use (p>0.05 for all comparisons). However, there was a trend toward better preservation of donor GFR at 1 month for marijuana using donors vs. non-marijuana using donors (-33.3% vs. -38.6%; p=0.07) respectively. Marijuana kidney recipients and non-marijuana kidney recipients were similar in creatinine change and percent creatinine change at all time periods. At 1 month, marijuana kidney recipients showed a lower percent change in GFR compared to non-marijuana kidney recipients (+0.9% vs. +20.4%; p=0.035) respectively. However, for all other time points (6 months, 1 year, and 5 years), there was no difference in percent GFR change between marijuana kidney recipients and non-marijuana kidney recipients (p>0.05 for all comparisons).

Conclusions

There was no difference in renal function between marijuana using donors and non-marijuana using donors and no long-term differences in renal function between non marijuana kidney recipients and marijuana kidney recipients. Considering individuals with a history of marijuana use for live kidney donation could increase the donor pool and yield acceptable outcomes.

Funding

None