The Clinical Conundrum of Cannabis : Current Practices and Recommendations for Transplant Clinicians: An Opinion of the Immunology/Transplantation PRN of the American College of Clinical Pharmacy
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved..
Cannabis, or marijuana, comprises many compounds with varying effects. It has become a treatment option for chronic diseases and debilitating symptoms, and evidence suggests that it has immunomodulatory and antiinflammatory properties. Transplant centers are more frequently facing issues about cannabis, as indications and legalization expand. As of February 2020, 33 states and the District of Columbia have legalized medical cannabis, and 14 have legalized recreational cannabis. Moreover, 8 states have passed legislation prohibiting the denial of transplant listing solely based on cannabis use. Studies demonstrate the potential for significant pharmacokinetic and pharmacodynamic interactions between cannabis and immunosuppression. Additionally, safety concerns include increased risk of myocardial infarction, ischemic stroke, tachyarrhythmias, malignancy, neurocognitive deficits, psychosis, other neuropsychiatric disorders, cannabis use disorder, respiratory symptoms, and infection. A recent retrospective database study found a negative association between documented cannabis use disorder and graft survival, but little additional evidence exists evaluating this relationship. In the absence of robust clinical data, transplant centers need a clear, reasoned, and systematic approach to cannabis. The results of our national survey, unfortunately, found little consensus among institutions. As both recreational and medicinal cannabis become more ubiquitous nationwide, transplant centers will need to develop comprehensive policies to address its use.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:105 |
|---|---|
| Enthalten in: |
Transplantation - 105(2021), 2 vom: 01. Feb., Seite 291-299 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Melaragno, Jennifer I [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Immunosuppressive Agents |
|---|
| Anmerkungen: |
Date Completed 08.02.2021 Date Revised 02.10.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1097/TP.0000000000003309 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM309957052 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM309957052 | ||
| 003 | DE-627 | ||
| 005 | 20231225135041.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/TP.0000000000003309 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1033.xml |
| 035 | |a (DE-627)NLM309957052 | ||
| 035 | |a (NLM)32413017 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Melaragno, Jennifer I |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Clinical Conundrum of Cannabis |b Current Practices and Recommendations for Transplant Clinicians: An Opinion of the Immunology/Transplantation PRN of the American College of Clinical Pharmacy |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 08.02.2021 | ||
| 500 | |a Date Revised 02.10.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a Cannabis, or marijuana, comprises many compounds with varying effects. It has become a treatment option for chronic diseases and debilitating symptoms, and evidence suggests that it has immunomodulatory and antiinflammatory properties. Transplant centers are more frequently facing issues about cannabis, as indications and legalization expand. As of February 2020, 33 states and the District of Columbia have legalized medical cannabis, and 14 have legalized recreational cannabis. Moreover, 8 states have passed legislation prohibiting the denial of transplant listing solely based on cannabis use. Studies demonstrate the potential for significant pharmacokinetic and pharmacodynamic interactions between cannabis and immunosuppression. Additionally, safety concerns include increased risk of myocardial infarction, ischemic stroke, tachyarrhythmias, malignancy, neurocognitive deficits, psychosis, other neuropsychiatric disorders, cannabis use disorder, respiratory symptoms, and infection. A recent retrospective database study found a negative association between documented cannabis use disorder and graft survival, but little additional evidence exists evaluating this relationship. In the absence of robust clinical data, transplant centers need a clear, reasoned, and systematic approach to cannabis. The results of our national survey, unfortunately, found little consensus among institutions. As both recreational and medicinal cannabis become more ubiquitous nationwide, transplant centers will need to develop comprehensive policies to address its use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Medical Marijuana |2 NLM | |
| 700 | 1 | |a Bowman, Lyndsey J |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Jeong M |e verfasserin |4 aut | |
| 700 | 1 | |a Lourenco, Laura M |e verfasserin |4 aut | |
| 700 | 1 | |a Doligalski, Christina T |e verfasserin |4 aut | |
| 700 | 1 | |a Brady, Bethany L |e verfasserin |4 aut | |
| 700 | 1 | |a Descourouez, Jillian L |e verfasserin |4 aut | |
| 700 | 1 | |a Chandran, Mary M |e verfasserin |4 aut | |
| 700 | 1 | |a Nickels, Mark W |e verfasserin |4 aut | |
| 700 | 1 | |a Page, Robert L |c 2nd |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Transplantation |d 1963 |g 105(2021), 2 vom: 01. Feb., Seite 291-299 |w (DE-627)NLM000023787 |x 1534-6080 |7 nnns |
| 773 | 1 | 8 | |g volume:105 |g year:2021 |g number:2 |g day:01 |g month:02 |g pages:291-299 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/TP.0000000000003309 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 105 |j 2021 |e 2 |b 01 |c 02 |h 291-299 | ||