Opioid Epidemic Increases Number of Organ Donors Dying From Drug Overdose

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The age-standardized rate of death from drug overdose has more than tripled, from 6.8 per 100,000 persons in 1999 to 20.8 per 100,000 persons in 2016.  There is also a severe shortage of organs in the United States, with approximately 120,000 patients on national waitlists and only 10,281 donors in 2017.  Historically, organs from trauma deaths have demonstrated the best outcomes, while overdose deaths are often designated as increased infectious risk donors (and discarded), due to behaviors that increase the risk of HIV, Hepatitis B and Hepatitis C.  Using registry data that tracks transplant outcomes, Durand and colleagues recently demonstrated that 5-year patient survival and overdose death organ recipients and trauma death donors was similar and suggesting that organs from drug overdose deaths should not be discarded based on increased infectious risk.

Vaduganathan and colleagues evaluated trends in organ donation and transplants among drug overdose deaths.  Between 1999 and 2017, 37,232 hearts were recovered for transplants.  In 1999, only 1.5% of donors had died from drug overdose, while by 2017, 17.6% of donors had died from a drug overdose, a more than 11 fold increase.  The authors concluded that this large increase can not be explained by the increased number of deaths alone, and that targeted campaigns promoting organ donation in populations affected by opioid abuse and changing perceptions about the acceptability of these organs by transplant physicians are also contributing.  However, the total number of individuals dying of a drug overdose who become an organ donor remains small, less than 1%.   

References

Durand CMBowring MG, et al. The drug overdose epidemic and deceased-donor transplantation in the United States: a National Registry study. Ann Intern Med >span class="NLM_year">2018;168:702-711.

Vaduganathan M, Machado SR, DeFilippis EM, Bajaj N, Stehlik J, Mossialos E, Jarcho JA, Mehra MR.Organ Donation and Drug Intoxication-Related Deaths in the United States. N Engl J Med. 2019 Feb 7;380(6):597-599


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