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Published on: April 16, 2019
Methadone maintenance therapy in liver transplantation
Modi Jiao1, Erica D Greanya, Mazhar Haque
1University of Toronto Scarborough, Toronto, Ontario.
Progress in Transplantation (Aliso Viejo, Calif.)
|October 9, 2010
Summary
Patients with cirrhosis due to hepatitis C virus (HCV) face difficult choices regarding methadone maintenance therapy (MMT) for opioid addiction. Discontinuing MMT risks relapse, while continuing it may exclude them from liver transplantation.
Area of Science:
- Hepatology
- Transplantation Medicine
- Addiction Psychiatry
Background:
- Chronic hepatitis C virus (HCV) infection is the leading cause for liver transplantation in North America.
- Parenteral illicit drug use is the primary route of HCV transmission.
- Methadone maintenance therapy (MMT) is a standard treatment for opioid addiction, often including patients with chronic HCV.
Purpose of the Study:
- To explore the complexities of liver transplant candidacy for patients with end-stage cirrhosis on MMT.
- To examine the controversy surrounding MMT requirements for liver transplant eligibility.
- To review post-transplant literature concerning MMT in liver recipients.
Main Methods:
- Literature review of MMT in end-stage cirrhosis patients.
- Analysis of transplant center policies regarding MMT.
- Exploration of patient dilemmas concerning MMT and transplant eligibility.
Main Results:
- Transplant centers have conflicting policies on MMT for liver transplant candidates.
- Patients face a dilemma: discontinue MMT (risking relapse) or continue MMT (risking transplant exclusion).
- Stable patients with end-stage cirrhosis on MMT are in a challenging position.
Conclusions:
- The management of MMT in patients with end-stage cirrhosis awaiting liver transplantation requires careful consideration.
- Current policies create significant barriers for eligible patients.
- Further research and standardized guidelines are needed to address MMT in liver transplant candidates.
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