Levels and in-unit stability of 11-nor-9-carboxy-9-tetrahydrocannabinol (9-carboxy-THC) in donor platelets and whole blood: is enough present to have an impact on recipients?

Abstract

Abstract Objective The safety of the United States donor blood supply has been questioned in the context of recreational marijuana legalization in Colorado and other states nationwide. It is unclear whether cannabis use by donors presents a danger to recipients, either through direct toxicity or socioeconomic ramifications. Our objectives are to both determine if the active metabolite of tetrahydrocannabinol (THC), 11-nor-9-carboxy-9-tetrahydrocannabinol (9-carboxy-THC), is present in donated units in a dosage high enough to impact the recipient and to assess for in-unit metabolism or degradation. Methods We will quantify the amount of 9-carboxy-THC in platelet units donated by self-reported cannabis users through liquid chromatography with tandem mass spectrometry (LC-MS/MS) testing and correlate the assay data with donor survey responses. To gain insight into in-unit metabolite stability, we also will test whole blood units at several time points throughout storage, collected from participants who self-report taking a known oral dose of THC prior to donation. Results Institutional review board approval for a study evaluating marijuana at a children’s hospital presented a challenge, requiring the addition of an organizational risk review and an update to the hospital transfusion consent for approval. Thus, the projected timeline of this study has been extended. Study recruitment flyers and an email screening survey have generated interest from volunteer donors. The email survey was sent to 9,208 donors who had previously donated at least once, from which we received 372 responses (4.04% response rate). Of the respondents, 49 individuals reported daily marijuana use, 33 reported marijuana usage 4-6 times per week, 32 reported usage 1-3 times/week, 30 reported usage 1-3 times/month, 52 reported rare usage, and 167 reported never using marijuana. Overall, out of the survey respondents, over 50% reported at least some marijuana usage, and 31% reported at least weekly marijuana usage. Although this number is small, our prior study found that many were repeat donors. Research visits are currently being scheduled for interested participants. Conclusions This study highlights the challenges of performing marijuana research at a children’s hospital and illustrates why there is a lack of published data evaluating the effects of recreational marijuana legalization. Although completion of this project investigating this controversial topic has been delayed, persistent advocation for this area of interest is opening doors for future studies and will hopefully pave the way to fill our knowledge gaps. The results of this research study will inform decisions regarding donor eligibility and safety of the national blood supply as well as address associated socioeconomic implications.