Improving Organ Utilization to Help Overcome the Tragedies of the Opioid Epidemic

Abstract

Death rates from drug overdoses have nearly doubled since 2003, with over 47 000 deaths in 2014. This is largely attributable to the opioid epidemic. If the unfortunate deaths of otherwise healthy people have yielded an increase in organ donors, then this might serve as perhaps the only comforting factor among this tragic and unnecessary loss of life. In this viewpoint, we present data from the Organ Procurement and Transplantation Network (OPTN) that show how the greatest relative increases in the mechanism of death among deceased donors from 2003 to 2014 were drug overdoses. Unfortunately, despite the absolute increase in the number of donors who died from a drug overdose, the mean organ yield was significantly lower than in other categories, in part due to concerns about disease transmission. In this paper, we present data on the changes in donation from donors with a drug overdose as a result of the opioid epidemic and discuss the need to educate transplant candidates and their physicians about the low risk of disease transmission compared to the greater risk of dying on a transplant waitlist.

Keywords: donors and donation; donors and donation: deceased; editorial/personal viewpoint; ethics and public policy; organ procurement and allocation.

Conflict of interest statement

Disclosure

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

© Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Figures

Figure 1

Number of organ donors in the United States who died from a drug overdose in (A) 2003, (B) 2007, (C) 2010, and (D) 2014. Numbers in figure represent the OPTN/UNOS region. OPTN, Organ Procurement and Transplantation Network; UNOS, United Network for Organ Sharing.

Figure 2

Number of deaths from a drug overdose in the United States in (A) 2003, (B) 2007, (C) 2010, and (D) 2014. Numbers in figure represent the OPTN/UNOS region. Data based on Centers for Disease Control and Prevention, National Center for Health Statistics, Compressed Mortality File 1999–2014 on CDC WONDER Online Database, released December 2015 (2). OPTN, Organ Procurement and Transplantation Network; UNOS, United Network for Organ Sharing; CDC, Centers for Disease Control and Prevention.

Figure 3

(A) Mechanism of death for deceased liver donors in the United States from 2003 to 2014. (B) Percentage of organ donors classified as “increased risk” based on mechanism of death.