With the consistent need for organ donors as demand continues to outweigh supply, organ donation from people who die of overdose is on the rise.

In a study published in the Annals of Internal Medicine, investigators examined the effects of organ transplants from donors who die of overdose vs those who die from trauma or medical issues. The researchers determined that outcomes in transplants from people who died of overdose were noninferior to outcomes in transplants from other donors.

For both kidney and liver transplants, 5-year patient survival rates for those who received organs from people who died of overdose were higher than in those who received organs from donors who died from medical reasons. Results for heart transplants showed a similar but slightly higher survival rate for patients who received organs from donors who died from overdose than those who died from trauma or medical death. The survival rate was also slightly higher for those who received lung transplants from people who died of overdose. Although the study incorporated various types of donated organs, it did not distinguish between opioid and nonopioid overdoses.


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The investigators also discussed some risks of using organs from people who die of overdose, including the increased risk for infectious diseases, the possibility of hepatitis C virus infection — which could affect transplant outcome — and concerns about compromised organ quality resulting from illicit drug use. Although these risks should be considered, currently, a large number of organs are discarded. Overall, the discard rate for organs from those who die of overdose is higher than for those who die from trauma or because of medical reasons. The authors concluded that ideally this discard should be minimized so that a greater number of organs are available for transplant, especially considering the similar or higher survival rates for patients who receive organs from those who die of overdose.

Reference

Durand CM, Bowring MG, Thomas AG, et al. The drug overdose epidemic and deceased-donor transplantation in the United States: a national registry study [published online April 17, 2018]. Ann Intern Med. doi:10.7326/M17-2451