An ironic ‘silver lining’ to the opioid crisis: More organs available for transplant

Monitor staff
Published: 5/25/2019 9:47:33 PM

One of the painful ironies of the drug overdose crisis in America is that even as it continues to take the lives of addicted people, it is indirectly helping save other lives through increased availability of organs for donation.

“This is a bad news story that has a silver lining,” said Dr. Michael Daily, chief of solid organ transplants at Dartmouth-Hitchcock Medical Center in Lebanon. “If I could solve this – overdoses – in some way, I certainly would. We don’t look at this as a boon for the industry, it’s making lemonade out of lemons.”

Last year in New England, 24% of all organ donors died as the result of a drug overdose, according to New England Donor Services, compared to less than 4% in 2010, before the opioid crisis hit.

That huge increase is seen nationally, as well. For example, in 1999, fewer than one out of every 50 hearts available for transplant in the U.S. came from people who died of drug overdoses, while in 2017 the figure was one out of every six hearts.

This increase, however, has not eliminated the backlog of patients seeking organ donations. The American Transplant Foundation estimates that 114,000 people are on waiting lists for at least one type of life-saving organ.

Daily says the Dartmouth-Hitchcock Transplant Center has “about 100 people” on its list waiting for a new kidney, the only organ that the center currently transplants. The center performed about 20 kidney transplants last year; Daily said it may add pancreas transplants in the future.

“Overall, the absolute number of transplants per year has gone up, and part of that is attributable to these drug-overdose donors, but unfortunately we’re still putting more people on the list,” Daily said.

Nonetheless, it’s true that without donations from overdose victims, the shortfall of available organs would be even worse.

Aside from the opioid crisis, an important fact in the increase of donations is that people are more confident in the safety and health of organs from overdose victims.

“When it first started happening, everybody was really scared of these organs. Someone died with a needle in their arm – what if they just got hepatitis today and we can’t detect it?” said Daily.

“I think a lot of the concern initially was from professionals. The idea of ‘first, do no harm’ … to not transmit (disease). As we realized how unlikely it was, we realized we were harming them by not offering them these organs,” he said.

Faster and more accurate testing such as nucleic acid testing, which can detect genetic material of many disease microorganisms in organs, has made the difference.

“There’s a 5-in-10,000 chance of transmission” with those tests, Dailey said. “That is much less than the chance of getting in a car wreck on the way here.”

In some ways, victims of drug overdoses are good candidates for organ donation.

They are generally younger than the overall population of donors and often have not suffered any trauma such as might be found in car accident victims, a common source of organs. Further, victims of opioid overdose usually die because their body stops breathing, meaning they are often brain dead but with organs are still healthy. If these organs are kept perfused – supplied with oxygen – they can remain viable for days.

(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com.)


Concord Monitor Office

1 Monitor Drive
Concord,NH 03301
603-224-5301

 

© 2019 Concord Monitor
Terms & Conditions - Privacy Policy