Opioid Epidemic: Creating More Organ Donors

Photo by Carol Duff

Health Editor’s Note: This is a scenario that I would hope that no one will have to face in life, but most of the time hope does not count for much when we are living life.  If you needed an organ for a transplant for a family member or yourself, would you accept an organ from someone who died of an overdose of opioids?  You might think that the organs of someone who died from an overdose of opioids would be tainted.  Not so.  Organs from those who die from an overdose of opioids are just as healthy as those taken from a motorcycle accident victim. 

The ONLY upside of the current opioid epidemic would be an increased number of organs that become available.  Because the organ was once in someone who took/overused narcotics, is no sign that the organ, if transplanted into you or a family member would, be harmful to a body.

The number of organ donations can never keep up with organ transplant demands.  According to the www.organdonor.gov website at least 20 die per day waiting for an organ donor.  At least 116,000 women, children, and men were on the national transplant list as of August 2017.  In 2016, 33,611 transplants were performed.

Every ten minutes a person is added to the transplant list with only three of every 100 people dying in such a way that organs are donate-able.   In the U.S., 95% of the population questioned are in favor of donation of organs but only 54% are signed up as actual donors.  Since 1991 organ transplants and donors have remained have remained at about the same levels with the numbers who need transplants (on waiting lists) soaring.  One donor can save eight lives with two kidneys, two lungs, a  heart, a liver, a pancreas, and intestines……Carol

Transplant Docs Too Picky About Organs from Overdose Deaths?

New evidence suggests these organs are perfectly OK

by F. Perry Wilson MD, MSCE

April 16, 2018

A side effect of the opioid epidemic is a surge of potential organ donors that died after overdose. In this 150-Second Analysis, F. Perry Wilson, MD, MSCE, examines a study that shows that organs from donors who overdosed are rejected more frequently than organs from other donors but that, importantly, the organs that do get transplanted fare just as well as organs from traditional donors.

Imagine you are a dialysis patient. Three days a week, you spend 4 hours in a chair hooked up to a dialysis machine. You’ve been on the transplant waitlist for 4 years. Finally, you get the call. There’s a kidney for you. But the donor died due to a drug overdose. Do you say yes?

This phone call is coming more and more frequently as the opioid epidemic continues to claim lives. But until now, we didn’t have enough data to inform an answer to the question. Now this paper appearing in the Annals of Internal Medicine suggests very strongly that if you (or your patient) gets that call, you should say yes.

Researchers used data from the Scientific Registry of Transplant Recipients which records data from every organ transplant in the U.S., including the donor’s cause of death.

The “ideal” donor — though ideal doesn’t feel like the right word here — is a young, healthy individual who suffered brain death due to trauma. As you can see from the chart, roughly 40% of donors met that criteria, while 55% died due to medical causes.

Over the 17 years examined in the study, just around 5% of donors had died from an overdose, but that number has skyrocketed recently.

In the year 2000, 1% of organ donors had died of overdose. Today, 13.4% of donors have died from an overdose. And in areas endemic for opioid abuse, that number is even higher – it’s around 35% in Massachusetts right now.

Once an organ donor is identified, organs are procured, but that’s not the end of the story. Some organs never find a willing recipient – these become “discards” and the data clearly shows, even after adjustment for multiple factors, that organs from those who died of drug overdoses are discarded more frequently than organs that come from trauma patients.

But is that evidence of smart practice, or just bias? Are these bad organs?

The authors argue that these organs are perfectly fine, based on the fact that the organs from donors after drug overdose do just as well as organs from individuals who died after trauma.

In other words, we may be discarding these organs inappropriately, and given the necessity to increase the organ pool (there are 120,000 individuals on organ wait lists and just over 10,000 donors in 2017), we should make efforts to increase transplantation rates among individuals who died of drug overdoses.

Now we need to be a bit careful here. Maybe the overdose organs that get transplanted do so well because physicians and patients are being so picky about them. It’s reasonable to think that individuals may only be willing to accept an organ from a donor who overdosed if it is essentially perfect in every other way.

But data like this helps us make better choices – it moves us from conjecture and gut instinct to hard evidence, and in this case the evidence is leading us to give these organs a second look.

  1. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine. He is a MedPage Today reviewer, and in addition to his video analyses, he authors a blog, The Methods Man. You can follow @methodsmanmd on Twitter.

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  1. Not a word about the “opiod epidemic” deaths where the death statistics from fentanyl and heroin are mixed in with ordinary opiods to make them seem as dangerous as heroin. Or the fact that people who need these pain meds are being turned away by doctors afraid for their licenses while street drug sales are through the roof. Carol, do you and Mr. Duff even live in the same house? Surely you must know about all of this! How about something about the organ harvesting going on wholesale across the pond? No?

    • Nawlins, I have commented on the opioid epidemic…..fentanyl, heroin, morphine, etc. in the recent past, more than a few times. Maybe you could look in the archives. I have also addressed other issues regarding drugs, doctors, etc. I know about , organ harvesting, but this specific article was simply addressing the issues of acceptance of transplanted organs from those who have died from narcotic overdoses. Topics are separate. Seriously, stop reading what I write if all you can do is criticize for what you think I should write. Carol

  2. After screening for Hep, HIV, etc…, I’m sure these organs are fine. But if families knew about the hypocrisy of pharmaceutical companies and our drug running intel agencies, they wouldn’t donate a fingernail to the corporate health care beast.

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