Mehra MR, et al. New Engl J Med. 2018;doi:10.1056/NEJMc1802706.

May 17, 2018
2 min read

Organs donated after drug overdose safe for transplantation


Mehra MR, et al. New Engl J Med. 2018;doi:10.1056/NEJMc1802706.

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Considering the ongoing opioid epidemic in the United States, researchers confirmed that survival rates among transplantation recipients who received organs from patients who died of drug overdose were similar to survival among recipients from donors who died of other causes.

Josef Stehlik, MD, MPH, medical director of the Heart Transplant Program at the University of Utah Health, told Healio Gastroenterology and Liver Disease that because donations from drug overdose cases often occur in hospitals that are not transplant centers, there may be bias against their use.

“Our data show otherwise,” Stehlik said. “What physicians should take away is that they should not discard an opportunity for organ donation from patients who died of drug overdose. Many of these patients are designated organ donors and we should do our best to honor their wishes. Our data confirm that these organs could save many lives.”

To confirm the outcomes of patients who received organs from donors who died of drug overdose, Stehlik and colleagues reviewed data collected between 2000 and 2016 from the U.S. United Network for Organ Sharing. Additionally, the researchers gathered data from the Eurotransplant database to compare the rates of death of drug overdose.

In the U.S., the proportion of organ donors who died of drug overdose increased significantly from 1.2% in 2000 to 13.7% in 2016 (P < .001), whereas the researchers observed no significant change in the frequency of death from drug intoxication or overall number of organ donors in Europe.

“We selected heart and lung transplantation for the study,” Stehlik said, regarding the 1-year survival rate comparison between heart and lung transplantations from donors with different causes of death. “The reason is, these organs are the most sensitive to lack of blood flow and oxygen flow during the process before donation.”

After adjusting for baseline characteristics of donors and recipients, as patients who die of drug overdose tend to be younger and may have comorbidities tied to drug abuse, the researchers observed no significant difference in survival between recipients of organs from donors who died of drug overdose and recipients from donors who died of blunt head injury for heart transplantation (HR = 0.85; 95% CI, 0.71-1.02) or lung transplantation (HR = 0.87; 95% CI, 0.72-1.06). Results were similar for comparisons involving other causes of death among donors.

While data were not presented for other organs, Stehlik said he has observed similar safety in other organs and was confident results would be similar for cases of liver or kidney transplantation.

“Any publications that are connected to transplantation are somewhat sensitive because these things happen during a time when somebody is losing a beloved family member, and in this case, it was connected to drug abuse,” Stehlik said. “Of course, we don’t want the message to come through that it’s great that we’re seeing more donors. The message is clearly that this is a problem; this is just another facet of the opioid crisis in which we see another impact on society. In the unfortunate circumstance that it happens, it’s important to educate all the donors, patients’ families, and physicians on the safety of using these organs.” – by Talitha Bennett

Disclosure: Stehlik reports no relevant financial disclosures. Please see the full study for the other authors’ relevant financial disclosures.