The opioid epidemic has been deemed the most critical public health challenge of our time by the American Medical Association. In 2017 opioid overdoses resulted in an estimated 47,600 deaths in the US, which accounted for over two-thirds (68%) of the nation’s total drug overdoses for that year.1Yet, despite the numerous negative consequences this epidemic has had on the American public, it has aided in providing for an increase in the available human organs for transplant. For this reason the opioid epidemic may be helping to solve the organ shortage crisis.

 

The Organ Donation Shortage

There are currently not enough adequate vital organs for transplantation. The data trend for years now has demonstrated an increased need for organ transplants, but the numbers of organ donors has been increasing at too slow a rate to meet the population’s existing demands.2The resultant organ shortage crisis has subsequently caused an increased number of patients on transplant lists, as well as the number of individuals who die while on an organ-transplant waiting list.3As of January 2019 there were over 113,000 individuals on the national transplant waiting list. In part due to these lengthy waiting lists, 20 people on average will die each day waiting for an organ transplant.2

 

Matching Organ Donors to Recipients

Finding a viable match between the organ donor and recipient is a crucial component in the process of transplantation in order to reduce the risk for a serious organ rejection and other undesirable health outcomes for the recipient. However, only 1 in 3 people die in a way that will allow for an organ transplant to even be a viable option.2From this already limited group of people finding a suitable match can be quite a complicated and difficult endeavor.

 

When a deceased person’s organs are being matched with a recipient various aspects of both the donor and recipient need to be considered. Only medical and logistical factors are used for organ matching. Personal and social characteristics play no role in this process.4The following factors are almost always taken into consideration regardless of the organ to be transplanted:5

  • Blood type
  • Body size (height, weight)
  • Severity of the patient’s medical condition
  • Distance between the donor’s hospital and the patient’s hospital
  • Time spent on the organ transplant waiting list
  • Patient’s availability
  • Pediatric status

 

Prior Concerns Related to Organs Donations From Opioid Overdoses

Concerns regarding the passing of chronic diseases such as HIV and hepatitis from donor to recipient previously prevented physicians from utilizing organs donated from individuals who passed away from opioid overdoses.6-8However, new research suggests that transplant candidates may face greater health risks remaining on a waiting list compared to receiving an organ from someone who died from an opioid overdose.7,8Researchers have also found that the health outcomes of individuals who accepted transplanted organs from these donors were no worse compared to people who received organs from healthy donors.7,8

 

Some of the general characteristics of overdose death donors may actually make them more favorable candidates for the transplantation of particular organs. For instance, donors who die from opioid overdoses are commonly under the age of 40 with lower rates of diabetes and hypertension. The health and survival outcomes of heart transplant recipients from these donors have been excellent when compared to donors whose death was not caused by an opioid overdose.9

 

Increased Utilization of Overdose Donors

The rise in opioid overdose deaths coupled with this new research has led to a vast expansion of physicians utilizing organs from this donor pool.6,7 Although this may not be a sustainable option for solving the organ donation shortage, the research suggests that physicians should continue utilizing organ transplants from these donors as deemed appropriate and safe to help with this problem.8

 

References:

  1. Giroir BP. The opioid epidemic and emerging public health policy priorities. Ama-assn.org. https://www.ama-assn.org/system/files/2019-02/19-nac-opioid-epidemic-presentation_0.pdf. Published February 13, 2019. Accessed July 20, 2019.
  2. Organ donation statistics. Organdonor.gov. https://www.organdonor.gov/statistics-stories/statistics.html. Updated January 16, 2019. Accessed July 20, 2019.
  3. Abouna GM. Organ shortage crisis: problems and possible solutions. Transplant Proc. 2008;40(1):34-38. doi:10.1016/j.transproceed.2007.11.067
  4. UNOS. How we match organs. Unos.org. https://unos.org/transplant/how-we-match-organs. Accessed July 21, 2019.
  5. HRSA. Matching donors and recipients. Organdonor.gov. https://www.organdonor.gov/about/process/matching.html. Accessed July 21, 2019.
  6. Elsevier. Opioid epidemic increases number of organs available for transplant. Medicalxpress.com. https://medicalxpress.com/news/2019-06-opioid-epidemic-transplant.html. Accessed July 21, 2019.
  7. Cohut M. Organ donations from overdose deaths could alleviate crisis. Medicalnewstoday.com. https://www.medicalnewstoday.com/articles/321514.php. Published April 17, 2018. Accessed July 21, 2019.
  8. Phillips KG, Ranganath NK, Malas J, et al. Impact of the Opioid Epidemic on Heart Transplantation: Donor Characteristics and Organ Discard. The Annals of Thoracic Surgery. doi:10.1016/j.athoracsur.2019.03.076
  9. Commins J. Fatal opioid overdoses provide “favorable” organ donors. Healthleadersmedia.com. https://www.healthleadersmedia.com/clinical-care/fatal-opioid-overdoses-provide-favorable-organ-donors. Published June 6, 2019. Accessed July 21, 2019.