I have a person I am working with who's mother is seriously ill in hospital with amongst other critical issues 'progressive kidney failure'. The person I work with has along with their 16 year old son agreed to donate a kidney if they are a match and are being tested very soon for compatiblity.
The person has been stable on 30mg/ml of Methadone for a few years now, which had been reduced down considerable from their own motivation.
They dont know if they are ready to give up the methadone yet but are willing to come off if they are a match.

The questions are:

Would they need to come off the Methadone first and for how long would they need to be off.

Could they have good grounds for immediate retoxification after the operation.

As far as i can see, there would be no reason why the person should have to come off this small dose of methadone before the operation.

It should be the same as having routine booked surgery for any reason, in that the anaesthetist would need to be aware of the dose, and post op pain relief would need to be treated appropriately, but there is no need for the person to be "opiate free" before surgery of any kind.

If this person is deemed suitable in every other way, this small stable dose of methadone would not in itself be a contraindication.

If for some reason they decided to detox first, then I would personally be happy to "retox" them afterwards if requested, but probably they wouldn't want it by then.

This is a situation i have not yet come across! I hope all goes well.

This great scenario illustrates the idea of medication assisted recovery beautifully, I wish more people knew about it!

I was just going to say, it's different with Subutex, most anaesthetists in my experience will stop it, due to partial agonist interfering with both the anaesthtic and subsequent analgesia