Opioid OD Deaths Are Saving Lives Through Transplantation
More than 70,000 lives were lost to drug overdoses in the United States in 2017. Now, some of those touched by these tragedies might take a little comfort knowing their loved one's heart helped save a life.
Nearly 18 percent of hearts recovered for organ transplant in 2017 came from people who had died of drug intoxication. That number was up from 1.5 percent in 1999.
"Over the last two decades, we have seen a tripling from death rates from drug intoxication. At the same time, the number of organs has increased 12-fold, which shows that attitudes about whether [these organs] are viable have also started to change, with the most change in the last five years," said study senior author Dr. Mandeep Mehra. He is the medical director of the Heart and Vascular Center at Brigham and Women's Hospital in Boston.
One of the biggest concerns in using organs from people who abused drugs, particularly those who injected drugs, is the risk of serious infection. Potential infections include HIV and hepatitis C.
Mehra said that about four of 10 potential donors who die from drug overdoses have infections. But medications are now available that can effectively treat hepatitis C, he noted.
Dr. Alan Langnas, chief of transplantation at Nebraska Medicine in Omaha, added that the risk of someone getting HIV through a transplant is highly unlikely because testing is very good at detecting all but the most recent infections.
Last year, Mehra and his colleagues looked at all organ donations and found that one in 10 donated organs came from someone who had died of a drug overdose. That study also found that after a year, people who received organs from someone who had died from a drug overdose were doing just as well as those whose organs came from someone who died from other causes.
The latest study looked specifically at heart donations, to see if there were any geographical differences in the use of donor hearts from people who died from drug intoxication.
Between 1999 and 2017, more than 37,000 hearts were recovered for donation. More than one in six of those hearts came from someone who died due to drug intoxication, the investigators found.
There was a large variation in the use of donor hearts from drug deaths, the findings showed. Hearts from people who died of drug intoxication were most likely to be recovered in the Northeast, Midwest and the Southwest, according to the report.
Mehra said the biggest reason for the differences is likely an issue of supply and demand. "In areas where the population density is high, there's a demand in people who are waiting for heart transplant," he explained.
Nebraska was an area with a lower rate of donor hearts from drug deaths. Langnas said he suspected those lower rates were simply due to a lower population and less availability.
"There's no main barrier to using these organs. Every organ donor is unique, and the potential for organ damage from death isn't unique to drug deaths," Langnas said. He added that transplant programs are "enormously grateful" for families that are willing to donate organs under such difficult circumstances.
The study showed that for every 1,000 lives lost to a drug overdose, between six and seven lives are saved through heart transplants. Mehra added that the number underestimates the impact because many other organs can be used to save lives and drastically improve people's quality of life.
Mehra also said he hoped this finding might give some solace to the families of those who lost loved ones to drugs, and added that the researchers support and encourage all efforts to target the drug epidemic.
The study was published online Feb. 7 in the New England Journal of Medicine.
Learn more about becoming an organ donor from OrganDonor.gov.
SOURCES: Mandeep Mehra, M.D., chair, advanced cardiovascular medicine, executive director, Center for Advanced Heart Disease, and professor, medicine, Harvard Medical School and Brigham and Women's Hospital, Boston; Alan Langnas, M.D., chief, transplantation, University of Nebraska Medical Center, Omaha; Feb. 7, 2019, New England Journal of Medicine