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 23 May 2018

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News

Hospitals criticized for rejecting methadone patients for liver transplant

One third of liver transplant programs do not accept patients on methadone maintenance therapy, despite the lack of evidence to suggest it could be harmful to treatment, according to a report in the Journal of the American Medical Association.

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Dr Monica Koch and Dr Peter Banys, of the University of California, San Francisco, USA, surveyed all 97 adult liver transplantation programs in the USA to identify addiction-related criteria for admission to the United Network of Organ Sharing liver transplantation waiting list.

They found hepatitis C accounted for almost half of all liver transplantation causes (46%) followed by alcoholic liver disease (25%).

About 5.8% of people with HCV are prescribed methadone maintenance therapy to help them overcome their opioid habit.

A third of programs do not accept methadone patients for liver transplants.
JAMA

Of the 87 programs that responded to the survey, 56% accept patients who receive methadone maintenance, but one third require discontinuance of the treatment.

The researchers say requiring methadone patients to cease the treatment in order to qualify for a liver transplant can cause additional harm, and unfairly deprive them from receiving a transplant.

"There is no evidence base to support the practice of discontinuing methadone maintenance as a precondition for liver transplantation. Such a policy may induce relapse in formerly stable patients, and then, because of this, may disqualify these patients for surgery," they wrote.

They called for prospective liver transplant outcomes to be monitored, with particular emphasis on addiction and methadone maintenance therapy data.

Report Copyright: Englemed Health News at http://www.internationalmedicalnews.com

JAMA 2001; 285 (8): 1056-8
28 February 2001

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