Previouslydesigned

We are talking about a potential transplant recipient, not a healthy adult. He will be on lifelong immunosuppression and smoking marijuana has been associated with dangerous fungal infections in immunosuppressed patients. Also, there are drug interactions with marijuana and the immunosuppressive medications themselves.

Have you been told that smoking weed is OK by your transplant team? At the hospital where I work (in the US) our transplant doctors would view that as a red flag and it would likely delay or potentially exclude you from transplant. It may be different in South Africa, but I would hate for you to miss out on a transplant for something so trivial. If you haven't already, make sure to ask what things you can do to make yourself a better transplant candidate (including what to avoid).

Here's a quick case report and discussion about Tacrolimus and THC.

http://dx.doi.org/10.1155/2016/4028492

Again, I don't know how the transplant process works in South Africa. I can only speak to what I have experienced as an MD in the US. There likely will come a point (if it hasn't already happened) where you will be drug tested, possibly without you being explicitly told. Healthy, transplantable livers are pretty rare and you would hate to get passed over because your urine drug screen was positive for THC. Maybe your docs will come out and tell you: "hey, you are getting close to a potential transplant, but we need you to stop smoking pot for a few months". Alternatively, the transplant team may have a conversation that you are not a part of and pass you over for another young patient with no drug/substance abuse history and a clean drug screen. Personally, I wouldn't want to take that risk.