Researchers from Indiana University School of Medicine have suggested that scientists should expand and re-contextualise their understanding of the role of cannabis users in heart transplantation.
In their findings, published in the journal Circulation: Heart Failure, the researchers recommend a new approach to determining transplant candidacy that considers accepting cannabis users as donors.
The researchers have called into question the current policy that does not accept cannabis users as donors for heart transplantation. Lead author Onyedika Ilonze has suggested that current legislation has prevented many patients from receiving life-saving transplants.
Cannabis users are being left off the heart transplant waitlist
According to statistics from the Centers for Disease Control and Prevention, 48.2 million people, about 18% of the American population, use cannabis each year in the USA. Current recommendations from the National Library of Medicine state that ‘patients should demonstrate abstinence from recreational cannabis (three to 12 months based on their level of use) before activation on the heart transplant waitlist’.
The increasing rate of cannabis users and the burden of heart disease in the USA, have led researchers to question current legislation and attitudes towards cannabis use in the health sector.
“This is a dilemma in a time of increasingly favourable legislation regarding medical and recreational cannabis use. The dilemma is compounded by a rising need for heart transplants,” said Ilonze, who is an assistant professor of medicine at IU School of Medicine and a member of the Cardiovascular Institute.
The study, which examined findings from more than 200 publications, reviewed pre- and post-heart transplant considerations related to cannabis users. The study also compared attitudes from various clinicians towards opioid and cannabis use. Ilonze and the research teams say they found that many clinicians who chose not to pursue transplantation from cannabis users, had opinions that were based on outdated data or had no scientific basis.
More definitive data is needed
“Clinician bias, lack of consensus, and a dearth of research limit standard decision-making and worsen disparities in heart transplantation,” said Ilonze.
In their research, Ilonze and the researchers identify several other important areas where more research and definitive data are needed.
“We need to learn more about the interactions between cannabis and immunosuppressants, and to study the association between cannabis use and transplant survival. Clarifying this will move us forward and help us establish a standardised evaluation process,” explained Ilonze.
Khadijah Breathett, MD, associate professor of medicine and the director of health equity research at the Cardiovascular Institute, was also involved in this work. Breathett has said that this paper should be the starting point in developing a research programme that scientifically and ethically addresses the participation of cannabis users as heart transplant candidates and recipients.
“Dr Ilonze is performing culture-shifting work as an early career investigator,” Breathett said.