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Fatal overdoses in U.S. increasing pool of transplantable organs

(Reuters Health) - The increase in drug overdose deaths in the United States appears to have yielded a rise in organs available for transplant, and they are just as viable as those coming from people who have died from other causes, according to a new analysis.

The proportion of organ donors who died from a drug overdose has risen from 1.2 percent in 2000 to 13.7 percent in 2016, an 11-fold increase, the study team reports in The New England Journal of Medicine.

Overdoses are “a sad but definite organ donor source,” lead author Mandeep Mehra of Brigham and Women’s Hospital in Boston told Reuters Health in a telephone interview. “It’s a collateral effect of this terrible opioid crisis.”

The researchers found little difference between survival rates for the hearts and lungs that came from overdose victims and those culled from people who died from other causes - the most common of which was brain bleeding or stroke, followed by blunt-force head injury and gunshot wound.

For heart transplant recipients, survival was actually highest - although only slightly higher - if their heart came from a drug overdose victim.

Mehra said the findings probably apply to other types of organs such as livers and kidneys, which are more durable after the heart has stopped beating. But they were not part of the study, which was outlined in a research letter.

“We were more concerned about hearts and lungs because they’re the most vulnerable organs if deprived of oxygen for a period of time,” he said.

A similar trend has not been seen in Europe, according to Mehra, who is medical director of Brigham and Women’s Heart and Vascular Center.

“That’s the most interesting finding in this. The trend in Europe is absolutely flat,” he said, because “in Europe, the laws protect against opioid prescriptions, so the rate of medical prescriptions for opioid drugs in Europe is really low.”

A few years ago, he added, “there were approximately 52,000 deaths per year in the United States from drug abuse and in Europe there were only about 7,000.” That makes the U.S. rate much higher, even adjusting for population size, he noted.

“And when you look at the type of drug abuse in Europe, 81 percent of all the deaths that occur are from heroin, while opioid and prescription drug deaths are almost nothing,” Mehra said. “Here it’s the opposite.”

The research team is continuing to analyze this phenomenon, now “going regionally and state-by-state to see what the effect of this is in the U.S.,” Mehra said. “We’re even looking at states with different political leanings and seeing what effect that has on transplantation rates.”

SOURCE: The New England Journal of Medicine, online May 16, 2018.