IU researchers suggest the potential for a new approach to determining heart transplant candidacy

IU researchers suggest the potential for a new approach to determining heart transplant candidacy

Indiana University School of Medicine researchers have concluded that the medical and scientific community should expand and recontextualize its understanding of cannabis use and heart transplantation, suggesting the potential for an entirely new approach to determining transplant candidacy. Their results were recently published in the journal Circulation: Heart Failure.

Lead author Onyedika Ilonze, MD, said transplantation is a life-saving option for patients with end-stage heart failure, but unanswered questions about the legality and acceptability of cannabis use have prevented many patients from receiving transplants. Whether people who use cannabis should be considered candidates for a transplant is controversial, Ilonze said.

This is a dilemma at a time of increasingly favorable laws regarding medical and recreational cannabis use. The dilemma is compounded by an increasing need for heart transplants.”

Onyedika Ilonze, assistant professor of medicine, IU School of Medicine and member of the Cardiovascular Institute

The paper, resulting from an analysis of more than 200 publications, reviews pre- and post-heart transplant considerations related to cannabis use. It also compares the relative clinical attitudes toward cannabis and opiates. Ilonze and his team found that many of the reasons clinicians decide against transplanting patients who use cannabis are based on old data or have no scientific basis.

“Clinical bias, lack of consensus and a lack of research limit standard decision-making and exacerbate disparities in heart transplantation,” he said.

In the paper, Ilonze and his team identify several other extremely important areas where further research is needed.

“We need to learn more about the interactions between cannabis and immunosuppressants and examine the association between cannabis use and transplant survival,” said Ilonze. “Clarifying this will move us forward and help us establish a standardized assessment process.”

Khadijah Breathett, MD, is an associate professor of medicine and director of health equity research at the Cardiovascular Institute, who also participated in this work. She said this paper is the starting point for Ilonze to develop a research program that scientifically and ethically addresses the increasing use of cannabis among heart transplant candidates and recipients.

“Dr. Ilonze is doing culture-changing work as an early career investigator,” Breathett said.

Source:

Indiana University School of Medicine

Reference:

Ilonze, OJ, et al. (2022) Cannabis use and heart transplantation: differences and ways to improve outcomes. Traffic. doi.org/10.1161/CIRCHEARTFAILURE.122.009488.

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