Drug overdoses tied to 24-fold rise in organ transplants

Story highlights

  • 13.4% of organ donors in 2017, up coming from 1.1% in 2000, died by overdose, a study finds
  • “Underutilization of organs coming from these donors still occurs,” one expert says
A study published inside journal Annals of Internal Medicine on Monday at in which point reveals just how much of an increase there has been inside number of overdose-death donors, coming from being only 1.1% of all donors in 2000 to 13.4% in 2017.

The study suggests in which a rise in organ donations coming from drug overdose deaths could help America’s organ shortage — although the idea also shows in which between 2000 in addition to 2017, many organs coming from overdose-death donors were not used to save lives when they could have been.

How a 22-year-old's overdose death saved lives

“The current epidemic of deaths coming from overdose is usually a tragedy. the idea would certainly also be tragic to continue to underutilize life-saving transplants coming from donors,” said Dr. Christine Durand, assistant professor of medicine in addition to oncology at Johns Hopkins University, who led the study.

“We have an obligation to optimize the use of all organs donated. The donors, families in addition to patients waiting deserve our best effort to use every gift of life we can,” she said.

Durand added in which there are no regulations specifically pertaining to transplanting organs coming from overdose death in which could limit those organs coming from being used, although there are regulations related to donors at “increased risk” for transmitting certain viruses through organ transplantation.

“In our study, 56% of overdose-death donors were labeled as increased infectious risk donors. These donors require specialized testing for HIV in addition to hepatitis as well as specialized consent for the transplant recipient. There is usually stigma related to in which ‘increased infectious risk’ label,” Durand said.

“In reality, the ‘increased risk’ of HIV or hepatitis in these donors is usually very low,” she said.

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As of Monday afternoon, about 114,746 people inside United States were in need of a lifesaving organ transplant, although between January in addition to March, there were only 4,109 organ donors, according to the federal Organ Procurement & Transplantation Network.

Those numbers reveal a huge gap between supply in addition to demand.

“For people waiting on an organ transplant right at in which point, I would certainly like to think in which our studies bring them wish in which they could receive a transplant in addition to have more donors in which could help them,” Durand said.

“I also don’t want to lose sight of the people who made these transplants possible: the donors in addition to their families,” she said. “In a time of greatest tragedy, they made a powerful decision to save the lives of people waiting on a transplant. in which means they are generous, compassionate people. They are people I admire. They are the people who make organ donation in addition to transplantation possible.”

‘Many organs donated after overdose death were discarded’

The study involved data coming from the Scientific Registry of Transplant Recipients, which included information on donors, wait-listed candidates in addition to transplant recipients between January 2000 in addition to September 2017.

The researchers identified 7,313 overdose-death donors inside data who had at least one organ recovered during in which time. There were 19,897 transplants coming from those donors. The data showed in which the number of overdose-death donors increased by 17% per year between 2000 in addition to 2017.

In comparison, over in which time, the number of trauma-death donors increased by 1.6% per year, in addition to the number of medical-death donors increased by 2.3% per year.

US organ transplants increased nearly 20% in all 5 years

A trauma-death donor could be someone who died by drowning, gunshot or asphyxiation, among various other causes. A medical-death donor could be someone who died by hemorrhage, stroke or heart attack, among various other causes.

In particular, the researchers found in which the number of overdose-death donors climbed coming from 66 in 2000, encompassing 1.1% of the national pool, to 1,263 in 2016, encompassing 12.7%, in addition to then to 915 inside first nine months of 2017, encompassing 13.4%.

The researchers also found in which in 2016, overdose-death donors accounted for at least 10% of donors in 29 states, with the highest percentages seen in Massachusetts at 35.6%, fresh Hampshire at 32.4%, fresh Jersey at 25.7%, fresh York at 23.1% in addition to Maryland at 22.7%.

Overall, the researchers found a 24-fold increase in overdose-death donor transplants, coming from 149 in 2000 to 3,533 in 2016.

“Patients who received transplants coming from these donors had excellent outcomes; patient survival in addition to organ function were similar to cases when donors died due to trauma in addition to similar or better than cases when the donor died due to medical causes of death, like heart attack or stroke,” Durand said.

“What was somewhat surprising was in which, despite the Great outcomes we see in transplant recipients, many organs donated after overdose death were discarded — in which is usually, they were surgically recovered although then not used for transplant in any patient,” she said.

Drug overdoses contribute to record number of organ donors

During the course of the study, the researchers identified 1,665 kidneys, 501 livers, 117 hearts in addition to 23 lungs coming from overdose-death donors in which were recovered although discarded.

Those organs were discarded at a higher rate than those coming from trauma-death donors although lower than those coming from medical-death donors, the researchers found. For instance, kidneys were discarded at a rate of 14.1% among overdose-death donors, compared with 8.8% among trauma-death donors although 26.1% among medical-death donors.

“in which discard was primarily related to an increasing prevalence of hepatitis C infection among overdose-death donors in addition to increased infectious risk,” Durand said. “With transplant, you always have to balance the risk in addition to benefit,” she said. “Patients in addition to their transplant teams have to weigh the tiny risk of an infection like hepatitis C — for which we at in which point have a cure — against the risk of dying on the wait list.”

‘We need to save more lives’

The study had some limitations, including in which the researchers were unable to determine how many of the overdose-death donors died specifically of opioid drug overdoses versus non-opioid overdoses. Also, states in addition to jurisdictions vary in their reporting of specific drugs implicated in overdose deaths.

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“We at UNOS have witnessed the increase inside numbers of organ donors, especially over the past several years, resulting coming from the tragedy of the opioid crisis inside United States,” said Klassen, who was not involved inside fresh study.

“The study importantly illustrates in which recipient outcomes are similar to those obtained coming from donors who die coming from various other causes. the idea also illustrates how the transplant system has successfully incorporated the use of organs coming from these donors into clinical practice, resulting in benefits to many patients,” Klassen said.

“Underutilization of organs coming from these donors still occurs in addition to is usually probably underestimated in in which paper by looking at ‘discard rates’ since in which does not account for organs in which are never procured despite the possibility of providing benefit to potential recipients,” he said.

The editorial calls for enhanced efforts to provide organs for patients most likely to have long-term benefit coming from transplantation.

“We need to save more lives of persons awaiting organ transplant,” she wrote. “The transplant community should understand these fresh data in addition to forge ahead toward better transplant outcomes for more recipients.”

Source : Drug overdoses tied to 24-fold rise in organ transplants