Cannabis Use and Heart Transplantation: A Canadian Perspective

Abstract

Although cannabis was legalized in Canada until October 2018, there is no clear consensus among the heart transplant community with respect to transplant eligibility among cannabis users. We sought to determine prevailing attitudes towards cannabis use in heart transplant candidates amongst healthcare professionals in Canada, and to determine whether there are differences compared to jurisdictions where cannabis has not been legalized. A voluntary and independent web-based survey was distributed to members of the Canadian Cardiac Transplant Network. The survey questions were based on previous work by Neyer and colleagues who conducted a similar multi-national survey in 2016. There were a total of 38 providers representing 15 adult and paediatric transplant programs across the country that provided responses to assess current opinions and attitudes in regards to cannabis use and heart transplantation. Fifty-two percent of the respondents were in favour of listing patients who consumed medical cannabis, while only 5% were against listing, and 43% would only consider transplant listing with additional stipulations. This is less limiting compared to 35.6% of respondents in the 2016 survey conducted by Neyer et all who found listing patients who consumed medical cannabis unfavourable. Twenty-one percent of respondents were against listing patients who consumed recreational cannabis, which is again markedly less than the 72.5% of respondents from Neyer's survey. Sixty-seven percent did not believe that patients who consume cannabis legally through inhalation methods should be listed for transplant, while only 5% of respondents were against listing for patients who consume cannabis through oral ingestion. In the current Canadian context of legalized cannabis, there is heterogeneity of attitudes towards transplant eligibility depending on route of ingestion and pattern of use. Compared to other nations, Canadian health care providers may have less restrictive attitudes towards listing cannabis users for cardiac transplantation. Current attitudes towards cannabis use in transplant candidates should inform further research and guideline development.