Opioid Epidemic: Creating More Organ Donors

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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.

18 COMMENTS

  1. Excellent article.

    This is huge. In the US about 60,000 people overdose on opioids each year. They are often young and physically healthy.

    To put this in context, about 3,000 people are on the wait list for a new heart at any given time and about 3100 receive a heart transplant each year. 60,000 new potential donors a year is a game changer.

    The distinction between pharmaceutical opioids and other opiates — street injection Heroin — is probably worth remembering. Receiving an organ from a needle drug abuser is probably not worth the emotional and financial cost — particularly when clean organs from opioid abusers are available.

    • Correction: 16,000 prescription opioid deaths, not 60,000.

      60,000 overdose deaths from all drugs.

  2. I was surprised to find out the massive figures of American Vets addicted to Opiods and that there is a National Safety Counsel opioid memorial called “Prescribed to Death.”
    You should find this an interesting read Carol about the UK organ consent.

    The government is working to change the system of consent in England which permits the removal of organs for transplant. Are we being fully informed of the potential consequences?
    Losing a loved one can only be described as deeply saddening and devastating but at least when the cause of that death is unpreventable there is some solace that nothing further could be done. As my family and I are still feeling those effects from the recent loss of my mother I can truly empathise. God only knows what those that lose their children must feel, especially if their lives might have been extended sufficiently to be deemed saved by an organ transplant. After years on dialysis, patients, if they are lucky, may receive a transplant and enjoy a relatively normal, happy life, as my sister’s mother-in-law did until she passed in her 70s, years of freedom she may not have had without that transplant.

    You would think then that the proposed change in the law in England to automatically opt-in citizens to the organ donor list would fill me with hope but it doesn’t, as there are aspects to organ donation that require deeper inspection and a light shone on them for honest, public debate. As with most things in life, it is not a simple subject no matter how much we would wish it to be so.

    https://www.ukcolumn.org/article/no-time-to-die

  3. People who ride motorcycles without helmets make good organ donors. The squids, people who ride without helmets or any protection, are more than likely to end up as organ donors and the manner in which they drive those crotch rockets indicates they must obviously have a death wish. Young and stupid, fearless and invulnerable….yeah right.

  4. I have ALWAYS refused to be an organ donor. Always will.

    When I lived in Chicago, one of my girlfriends coworkers told us about the story of her ex boyfriend, a Judge who needed a liver transplant for cirrhosis. He tested positive for Cocaine use, so he was rejected when it was his turn on the list. Yes, a Federal Judge. Cokehead and alcoholic.

    I understand the reluctance to give a liver to someone who is going to immediately start abusing it, but the hypocrisy is still too much. They may be willing to TAKE from drug users, but they wont GIVE.

    My personal feeling is EFF anonymous organ donation unless the descendents of the deceased get a nice COMMISSION of the sale price on those organs.

    They may TAKE them off you for FREE, but they don’t GIVE ’em away, do they?

    Is EVERYONE equally eligible to receive an organ transplant regardless of socioeconomic status?

    Or are some animals MORE equal than others?

    “The costs will vary for each patient, based on insurance coverage, the type of transplant and the location of the transplant center. Patients will also incur lifetime medical expenses for follow-up care and prescriptions.

    Below is a list of average costs for transplants and first-year expenses*. The actual costs may be higher or lower than the figures listed here:
    • Bone Marrow (autologous): $375,000
    • Bone Marrow (allogeneic): $925,000
    • Cornea: $28,000
    • Heart: $1.2 million
    • Intestine: $1.5 million
    • Kidney: $330,000
    • Liver: $735,000
    • Lung: $785,000
    • Double Lung: $1 million
    • Pancreas: $315,000
    • Heart/Lung: $2.3 million
    • Kidney/Pancreas: $550,000
    • Kidney/Heart: $1.5 million
    • Liver/Kidney: $1.2 million”

    http://www.transplants.org/faq/how-much-does-transplant-cost

    • Doctors are no better than veterinarians. They will gladly sacrifice you or you child for money. The proof is the huge number of people that are addicted to pills in America — Not just the currently fashionable synthetic Heroin pills they get a commission for, but antidepressants, statins, and etc.

      Are you sure you want to make organ harvesting decisions even more of an economic decision than it already is?

    • Nope. Just ditch organ transplants altogether.

      If God or Nature has decided your number is up.

      It’s up.

  5. I read Mrs Duff’s prior article on Opiod addiction. It was a good read.

    Everyone should automatically become an organ donor in order to prevent hundreds of deaths each year, the Government’s chief doctor said today. This was in 2007

    Sir Liam Donaldson called for a change in the law so only those who register their objections are exempt from donating their organs after their death

    • Marukee, I think Sir Liam Donaldson is definitely onto something here. It would take energy to register an objection and if someone does not want to take the time, organs would be available…..lots and lots…..No looking for a donor card, no asking the family for permission to take organs….no one, at the time of the death, needs to make a decision as it was already made by default. Getting an organ for a transplant is not always the end ticket to health, with possible tissue rejection around the corner, but getting the numbers of available organs up, can make it possible for the first and second chances of transplantations. Carol

  6. 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

  7. 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.

  8. My GP from the same surgery where my wife was misdiagnosed for nearly 10 yrs due to lack of a proper examination gave me a prescription for 200 Co-Codimol tablets a month for back pain. No info was given to me on the addiction side. I reduced my prescription down to 100 a month and take 2- 4 a day now. Trying to stop altogether is not easy.

    • You have to just stop. It can be done.

      In my youth I was very much involved with a young lady who had been repeatedly raped by her father as a child. As a young adult she self-medicated — first with coke and then with crack. When I discovered this I called a rehab clinic in Oakland and asked if it was even possible to quit. They told me it was possible but unlikely. I asked if it was as hard to quit as Heroin. The guy said it was harder to quit than Heroin. He then said something I have never forgotten (which is the whole point of this story): “It’s as hard to quit as smoking.”

      People quit smoking all the time. Most people fail. Those who really know they have to quit, do quit. You can quit if you really want to. Just remember that it’s no harder to quit than smoking.

  9. I don’t know if there is some statistics around how much deceases by overused prescribed opioids but i guess they must be much less than with other ilegal narcotics only the mere fact pharmacological narcotics being fabricated by laboratories and supervised and approved by FDA while illegal drug you don’t know what you is buying and from where come or even less deceases than fatal cars accidents

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