Opioid Deaths Boost Organ Transplant Availability

Are these organs safe? A new study of transplantation records found no significant change in the recipients' chances of survival when organs came from a drug overdose victim.

The increase in opioid-related deaths has created a grim harvest of vital organs for transplant, a study shows.

Researchers found a more than 10-fold increase in the proportion of donors who died from drug overdoses between the years 2000 and 2016 in the United States, from 1.2% (59) to 13.7% (1,029).

"We were surprised to learn that almost all of the increased transplant activity in the United States within the last five years is a result of the drug overdose crisis," said lead author Mandeep R. Mehra, MD, medical director of the Heart and Vascular Center at Brigham and Women’s Hospital, in comments accompanying the study.

The central question posed in the study is whether or not organs taken from drug overdose victims are safe for transplants, and the evidence gathered suggests that they are.

The researchers:

• Looked at 17 years of transplantation records and found no significant change in the recipients' chance of survival when the organ donation came from victims of drug intoxication.
   
• Compared the survival rate of 2,360 patients one year after receiving a heart or lung transplant from donors who died from drug intoxication compared to recipients of organs from donors who died from other causes, including gunshot wound, asphyxiation, blunt head injury and intracranial hemorrhage or stroke.
   
• Focused on heart and lung data because these organs are the more sensitive to reduced oxygen supply that may occur during a drug overdose.
   
• Focused on survival in the first year, because these concerns would manifest shortly after the transplant.

Clinicians have been conservative when identifying organs from drug intoxication deaths. During an overdose, a person may experience prolonged episodes of low blood pressure that can reduce the supply of oxygen throughout the body.

There are also considerations that include infection risk, such as Hepatitis B and C and HIV, but this risk can be minimized with modern testing, the researchers said.

"I feel hopeful that doctors across the country will read this and feel confident that organs that pass the required tests are safe for transplant," said study senior author Josef Stehlik, MD, medical director of the Heart Transplant Program at University of Utah Health.