The number of post-overdose deaths is increasing in the United States[1]. These are young people who have often agreed to donate their organs. Their deaths could help to tackle the organ shortage in the U.S. Since 2000, the number of transplants performed following death by overdose has increased 24-fold. The viability of organs from increased-infectious risk donors, or IRDs, is a key issue.
Scientists at the John Hopkins University School of Medicine used data from the U.S. Scientific Registry of Transplant Recipients for a study published in the journal Annals of Internal Medicine[2]. They analysed the organs procured from 138,565 overdose-death donors between 2000 and 2017, and given to 337,934 recipients.
- In 2000, only 1% of transplants came from overdose-death donors compared to 13% in 2017.
- Transplant recipients have the same survival rate, regardless of the origin of the transplanted organ.
- Overdose-death organ donors are less likely to suffer from hypertension, diabetes or prior myocardial infarction.
- A greater proportion of them volunteer to be donors.
- Conversely, their organs are rejected more often because of HIV, hepatitis B or hepatitis C, and their creatinine levels are slightly higher.
- Fifty-six percent of organs procured from overdose-death donors pose an increased risk of infection, i.e. twice the risk associated with other donors.
Nevertheless, the study points out that, even with these increased risk donors, the “real risk of infection […] is extremely low” and that “the minor potential risks associated with IRD and HCV[3] must be carefully assessed in relation to the benefit that these organs can bring to transplant candidates”.
For further reading:
Canada: Increase in overdose-related deaths and organ donation
[1] Number of organ transplants on the rise in the United States and New Hampshire: an increasing number of organ donors die from an overdose.
[2] http://annals.org/aim/article/doi/10.7326/M17-2451
[3] Hepatitis C
Medical Press, American College of Physicians (16/04/2018)