As the number of lives claimed by America’s devastating substance abuse epidemic continues to climb, so too does the number of organs donated by the victims of these lethal overdoses. These organs are often perfectly viable but, for a variety of reasons, are routinely discarded — and a new report says reversing that trend could make a sizable dent in the nationwide donor organ shortage.
“We really hope that our study helps reassure patients and providers who are trying to make a decision about whether or not to accept an organ from an overdose death donor,” says Dr. Christine Durand, an assistant professor of medicine at Johns Hopkins Medicine and a co-author of the study, which was published Monday in the Annals of Internal Medicine.
The statistics around the substance abuse epidemic are staggering. Almost 64,000 Americans died of a drug overdose in 2016, according to the Centers for Disease Control and Prevention (CDC), and more than 115 Americans succumb to opioid abuse every single day. What’s more, a recent CDC report says the problem is only getting worse.
As those numbers creep upward, a bittersweet footnote has emerged: Since 2000, the number of organs donated by overdose victims has increased 24-fold, now accounting for 10% of all donations from deceased individuals.
The new study, which examined data from almost 338,000 transplant patients who received a donor organ between 2000 and 2017, says those organs could be life-changing, and life-saving, for the roughly 115,000 Americans who are currently waiting for a donor.
The data shows that “individuals who got organ transplants from donors who died of an overdose death had equally good, if not better, outcomes than organ transplants from other types of donors — donors who died from a trauma death or donors who died from medical causes,” Durand explains. This is likely because people who die of an overdose tend to be relatively young and otherwise healthy, with low rates of high blood pressure, diabetes, and other chronic illnesses, Durand says.
These viable samples could be invaluable, given that an estimated 20 people die each day while waiting for a transplant, according to the United Network for Organ Sharing. But even still, Durand says more than 2,000 organs from overdose victims were needlessly discarded over the course of the study.
This happens for two main reasons, she says. Sometimes, it’s because the donor had been diagnosed with hepatitis C, a blood-borne illness that is fairly common among intravenous drug users. Other times, hospital staff deemed the donors to be at an increased risk of infections such as HIV, hepatitis B, and hepatitis C, a designation mostly given based on behavioral and lifestyle risk factors. These are reasonable causes for pause, but neither explanation, Durand says, should automatically disqualify an organ for donation.
“If I needed an organ, I would accept both of those risks,” she says. “We now have curative treatment for hepatitis C, and the true risk that comes with that increased infectious risk donor label is quite small — it’s a less than one in 10,000 chance of HIV transmission and a less than one in 1,000 chance of a hepatitis C transmission.” Outside the realm of drug overdoses, doctors have also recently had success transplanting organs from patients with HIV and hepatitis C.
Given that the actual hazards are relatively minor, Durand says the increased risk of infection label “is a reflection of administrative burden, transport centers being worried about medical legal risk, and perhaps some stigma for patients associated with that label.” But if organs were not discarded for reasons like these, she says, significantly more people would get off the donor waiting list each year.
“It would mean hundreds, maybe thousands, more transplants a year,” she says. “It would just mean thousands more lives saved every year.”
And none of those lives could be saved without the selfless decisions of donors and their families, Durand adds.
“The donors and their families are making what’s really a very compassionate and courageous decision in the midst of tragedy,” she says. “These families are facing the death of a loved one, but they make the decision to donate and save a life.”
