The Use of Opioid Medications in Lung Transplant: A Scoping Review

Opioids are frequently used for dyspnea and analgesia in lung transplant patients; however, consensus is mixed regarding the impact of opioids on lung transplantation outcomes.

We performed a scoping review regarding opioid use and lung transplant including the use of opioids in the acute postoperative setting and long-term posttransplant and transplantation of patients with opioid use disorder (OUD). We defined the study sample, screening process, and outcomes and conducted a consensus quality ranking for each study.

Two studies addressing pretransplant opioid use, 7 studies addressing acute postoperative pain management, and 7 studies addressing chronic postoperative opioid use were included. Literature suggests pretransplant opioid use at low to moderately dosed opioids does not adversely impact transplant-related outcomes. Nerve blocks and cryoanalgesia reduce the need for postoperative opioids for analgesia. Chronic opioid use after transplant may be associated with poor outcomes.

Based on the available literature, low to moderately dosed opioids before transplantation do not have a negative impact on transplant-related outcomes, but chronic opioid use after transplant may predict complications. Overall, limited data are available to guide the use of opioids in lung transplantation. Additional studies are needed to evaluate the outcomes of patients with OUD on medication for OUD treatment.