Transplant patients need the physical, behavioral, and financial wherewithal to receive and care for their new organs. Anything that threatens their health or ability to comply with their healthcare team’s direction is a red flag.

A history of substance abuse is such a red flag, so much so that a patient currently abusing drugs is probably not going to be transplanted. But should patients with a past history of substance abuse be excluded from transplantation?

A multidisciplinary group of researchers from Temple University Hospital (TUH) and Temple University School of Pharmacy (TUSP) recently released a study that addresses this question. In the kidney transplant population they evaluated, they found that prior substance abusers did as well at one year following transplantation as those with no history of abuse. Based on their findings, the Temple researchers concluded that no evidence exists for excluding prior substance abusers from kidney transplantation.

While researchers cautioned that further prospective studies are necessary, these findings suggest that, with proper interventions including counseling and social support networks, along with sustained cessation, patients with a substance abuse history can successfully undergo transplantation and achieve good clinical outcomes post-transplant.

“For the transplant community, the social part of the patient’s profile is extremely important, sometimes just as much as their medical condition. But, often, their social histories overwhelm the process,” said Nicole Sifontis, PharmD, Clinical Associate Professor and Organ Transplantation Specialist at TUSP.

John A. Daller, MD, PhD, Director of the Abdominal Organ Transplant Program at TUH, agrees. “All substance abuse problems are not created equally,” he said. “In the past, I think healthcare providers may have viewed such patients’ transplant candidacies with skepticism, and people were denied access when they should have been listed for transplant. We need prospective studies to see how these patients do. That way, we can customize an approach to evaluating their past substance abuse history and, if appropriate, they can still get a transplant.”

Sifontis and Christopher J. Combs, PhD, Assistant Professor of Psychiatry and Behavioral Science at Temple University School of Medicine, presented the research findings, which received a “Poster of Distinction” Award, at the American Transplant Congress in May.

Christopher Combs, PhD, (left) and Nicole Sifontis, PharmD, with their award-winning poster presentation