Surgeons are now considering transplanting organs that are deemed less than “perfect” because of the current organ shortage and the influence of the opioid epidemic. This is an effort to expand the donor pool and save more lives, according to research published in The Annals of Thoracic Surgery, published by Elsevier. Research shows hearts from overdose donors may be as suitable as any others.
“The opioid epidemic has increased the proportion of hearts transplanted from overdose death donors (ODD),” said Nader Moazami, MD, of NYU Langone Medical Center in New York. “One of the roles of the transplant community is to at least partially mitigate the tragedy of this exponentially growing problem by maximizing the utilization of organs from ODD.”
The researchers evaluated trends in organ donation and transplants among drug overdose deaths. Dr. Moazami and colleagues used data from the Scientific Registry of Transplant Recipients for the years 2000 to 2017.
Of the 15,904 isolated heart transplants from adult donors during this period, opioid overdoses (10.8 percent) were the fourth most common cause of death, behind blunt injury (30.5 percent), hemorrhage/stroke (22.1 percent), and gunshot wound (18.3 percent).
In 2017, more than 20 percent of donor deaths in 11 states involved overdoses. In 2000, 33 states had less than 1 percent of donor deaths attributed to overdoses.
The researchers also noted that there has been a significant increase in the percentage of transplants that utilized ODD hearts. In 2000, only 1.1 percent of transplants involved hearts from ODD donors, while it rose to 6 percent in 2012, and then 14.2 percent in 2017.
“The dramatic increase in the rate of ODD utilization was striking, and it has increased concordantly with the rate of overdose deaths,” said Dr. Moazami. “The significant impact of the opioid epidemic on transplantation is one of the major reasons that organ transplant numbers have increased over the last several years.”
Researchers also found that donors who died from opioid overdoses were frequently younger than the age of 40 and had higher rates of substance abuse. However, they also had lower rates of diabetes and hypertension. This means the ODD hearts had “favorable heart donor quality”. It provided excellent outcomes equivalent to all other mechanisms of donor deaths, including non-overdose donors.
“We do not believe that overdose status alone is a valid reason to discard an otherwise viable donor heart, and this study supports that ODD organs should not be rejected due to inappropriate bias. With no significant difference in survival between ODD and non-ODD recipients, further expansion of this donor pool may be appropriate, with more hearts potentially used for transplantation,” said Dr. Moazami.
The opioid epidemic has also boosted the number of other available organs for donation in the US. Another study from Dr. Moazami and colleagues will be published in The Annals showing how opioid ODD provided 7 percent of the transplanted lungs from 2010-2017. This is a 2 percent increase in 2000-2007. The overall findings also concurred with those of this recent study, suggesting that ODD lungs do not pose any extra safety risk to transplant recipients. Click the link to see New Orleans's top rehab placement programs.
“In spite of the public crisis that the opioid overdose epidemic has created recently, the impact on organ transplantation and the unintended consequences of increasing the number of donor's hearts is noteworthy,” said Robert S.D. Higgins, MD, MSHA, Surgeon-in-Chief of The Johns Hopkins Hospital in Baltimore, STS President, and former president of the United Network for Organ Sharing (UNOS), who was not directly involved with the research.
“Many of these donors have been associated with diseases that have historically been considered 'high risk' by public health services. This important study highlights the need for additional research in this area to further define the 'risk' as well as the reward of expanding the donor pool to save more lives.”
If someone in the family is struggling with opioid or alcohol addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.
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