Lentine KL, Shah KS, Kobashigawa J, et al. - Researchers examined the influences of the prescription opioid epidemic in the setting of heart transplantation via analyzing a novel database, which links national U.S. transplant registry records to a large pharmaceutical claims warehouse (2007-2016) to characterize prescription opioid use before and after heart transplant, and associations with death and graft loss. Forty percent of 13,958 eligible patients were reported to have filled opioids in the year before transplant. Recipients who were female, white, or unemployed, or who underwent the transplant in more recent years had reported more common use. Opioid use posttransplant was continuously reported in 71% of those with the highest level of pretransplant opioid use. They observed 33% increased risk of death in the year after transplant in correlation with the highest-level use (> 1000 mg morphine equivalents) compared with no use. Stronger risk relationships with opioid use were evident in the first year posttransplant, with highest level use predicting 70% higher mortality over the subsequent 4 years (from > 1 to 5 years posttransplant).