Over­doses help cut trans­plant short­age

The Detroit News - - News - BY LAURAN NEERGAARD AP Med­i­cal Writer

Wash­ing­ton – Fa­tal drug over­doses are in­creas­ing or­gan do­na­tions, and re­searchers re­ported Mon­day that peo­ple who re­ceive those trans­plants gen­er­ally fare as well as pa­tients given or­gans from more tra­di­tional donors.

The find­ings could en­cour­age more use of or­gans from over­dose vic­tims. Re­searchers from Johns Hop­kins Uni­ver­sity found those trans­plants have jumped nearly 24-fold since 2000. That was be­fore over­doses were mak­ing head­lines or most trans­plant cen­ters con­sid­ered ac­cept­ing such or­gans.

In 2016, there were 3,533 trans­plants us­ing over­dose-re­lated do­nated or­gans, up from just 149 such trans­plants in 2000, the study found.

Deaths from over­doses are on the rise yet most oc­cur out­side hos­pi­tals, block­ing or­gan do­na­tion. Still, those deaths now ac­count for about 13 per­cent of the na­tion’s de­ceased or­gan donors, up from 1 per­cent in 2000, the re­searchers cal­cu­lated.

“This is not an ideal or sus­tain­able so­lu­tion to the or­gan short­age,” lead re­searcher Dr. Chris­tine Du­rand wrote in the jour­nal An­nals of In­ter­nal Medicine.

But with nearly 115,000 peo­ple on the na­tional wait­ing list for a trans­plant, the Hop­kins team con­cluded that use of or­gans from over­doses “should be op­ti­mized” be­cause many trans­plant can­di­dates could die wait­ing for an­other choice.

For Mon­day’s study, the re­searchers used a U.S. registry to com­pare the out­comes of nearly 338,000 pa­tients who re­ceived a trans­plant be­tween 2000 and 2016, from ei­ther a donor who died of dis­ease, trauma or an over­dose.

In gen­eral, trans­plant re­cip­i­ents’ sur­vival was sim­i­lar with an or­gan from an over­dose vic­tim. In fact, com­pared to donors who died of dis­ease, they some­times fared a lit­tle bet­ter be­cause over­dose donors tend to be younger and less likely to have had high blood pres­sure, di­a­betes or other ail­ments that can af­fect an or­gan’s func­tion, the re­searchers re­ported.

The study found that over­dosere­lated or­gans are more likely than other do­nated or­gans to be clas­si­fied as at “in­creased risk” of in­fec­tious dis­eases such as HIV or hep­ati­tis C. But the Hop­kins team said with im­proved test­ing of all do­nated or­gans to un­cover in­fec­tions the over­all risk for trans­plant can­di­dates is low, and should be care­fully weighed in de­ter­min­ing the best op­tion for in­di­vid­ual pa­tients.

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