Evidence map›Paper›PMID 40694388›Full record

ArticleHepatology communications2025

Opioid use after adult liver transplantation: Incidence, high-risk use, and adverse events in a large US cohort.

Sarah R Lieber, Olgert Bardhi, Yue Jiang, Alex R Jones, Prajwal Gowda, Shannan R Tujios, William Tirone, Madhukar S Patel, Parsia Vagefi, Steven Hanish and 9 more

Abstract read
In one paragraph

Article in Hepatology communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Sarah R LieberDivision of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-8304-4479
Olgert BardhiDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-5985-3372
Yue JiangDepartment of Statistical Science, Duke University, Durham, North Carolina, USA.ORCID 0000-0002-8334-0013
Alex R JonesDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-6922-9290
Prajwal GowdaDepartment of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Shannan R TujiosDivision of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0009-0005-8273-9400
William TironeDepartment of Statistical Science, Duke University, Durham, North Carolina, USA.
Madhukar S PatelDivision of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-7508-899
Parsia VagefiDivision of Surgical Transplantation, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Steven HanishDepartment of Transplant Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Van NgoDepartment of Pharmacy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Mary OlumesiDepartment of Pharmacy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Jessica F WhittDepartment of Pharmacy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Raelene TrudeauDepartment of Pharmacy, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Arjmand MuftiDivision of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Ben LippeDepartment of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Donna M EvonDivision of Digestive and Liver Diseases, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID 0000-0002-1414-1846
Amit G SingalDivision of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0002-1172-3971
Lisa B VanWagnerDivision of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0002-6264-2573

Funding

UT Southwestern Center for Translational MedicineUL1TR003163 · NCATS · UT SOUTHWESTERN MEDICAL CENTER · PI TOTO, ROBERT DANIEL · 2021 to 2025
$39.3M
NCATS NIH HHS UL1 TR003163
6 · The paper itself

Abstract

backgroundOpioid use contributes to significant morbidity, posing specific risks to liver transplant recipients (LTRs). This study aimed to characterize outpatient opioid use before and after liver transplantation (LT) and identify risk factors for high-risk, incident, and chronic use and related complications.

methodsAdult LTRs were identified from 2006 to 2021 in IQVIA PharMetrics Plus for Academics, a claims database representative of the commercially insured US population. Opioid use was evaluated 30-365 days after LT; high-risk use was defined as >50 morphine milligram equivalents (MMEs) per day or concurrent opioid-benzodiazepine use. Factors associated with use, including high-risk use, were identified using multivariable logistic regression analysis. Landmark analyses assessed the association between outpatient opioid use 30-120 days post-LT and incident adverse events (eg, psychiatric, substance use, chronic pain, fractures/falls, digestive).

resultsAmong 1338 LTRs, 899 (67.2%) received outpatient opioid prescriptions >30 days post-LT, of whom 553 (41%) had incident use; 122 (13.6%) had high-risk opioid use. Factors significantly associated with high-risk use were female sex, pre-LT opioid use, and psychiatric disorder. Opioid use was significantly associated with increased adverse events 120-365 days post-LT; 59% of LTRs with opioid use within 1 year of LT developed complications compared to 39% of non-opioid users during this window (p<0.001). In adjusted landmark analyses, low/moderate opioid use within 30-120 days post-LT was associated with 1.87 times the hazard of complications compared to no opioid use at 120 days post-LT (95% CI: 1.14-3.07) and high-risk opioid use was associated with 2.87 (95% CI: 1.05-7.85) times the hazard.

conclusionsPost-LT opioid use is associated with increased risk of adverse events. Caution is needed in opioid prescribing beyond the perioperative period, particularly for those with preexisting psychiatric conditions.

Indexed as

Analgesics, OpioidLiver TransplantationOpioid-Related DisordersPostoperative PainAdultAgedChronic PainCohort StudiesFemaleHumansIncidenceMaleMiddle AgedRisk FactorsUnited StatesAnalgesics, Opioidliver transplantopioid usepain managementsubstance use

Identifiers

PMID40694388
PMCPMC12282754

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.