Donor organs for transplants are in high demand. It’s estimated that 20 people die each day waiting for a transplant in the United States. But the chances for patients on the waiting list are also improving, as rates of organ donation keep rising. With four out of five donated organs coming from deceased donors, it’s important to know where these organs are coming from. A new study provides an answer: the opioid crisis. Between 2000 and 2016, the proportion of organ donors who died from drug intoxication grew an astonishing tenfold. The researchers also analyzed survival rates of 2,360 patients one year after receiving a donated heart or lung—the organs most likely to be affected by reduced oxygen supply during a drug overdose. They found that transplants resulting from these donations are just as successful as those from other sources. We spoke with study author Mandeep Mehra to learn more.

ResearchGate: Why is it important to study organ transplant trends? 
Mandeep Mehra: Donor organs represent a rare resource. In many cases, medical advances and public policy have decreased available organ donors. For example, high blood pressure treatment has reduced stroke related deaths, and helmet laws have resulted in fewer accidental deaths. Thus, we must always examine what other available sources for organ donation exist, and whether we are appropriately using all such resources to maximize the gift of life.

RG: What did this study examine? 
Mehra: The current study asked three questions. First, what accounts for the increase in organ donation in the US over the past 17 years, including a steep increase in the last five? We also asked whether causes of increased organ donation are similar in the US and in Europe. Finally, we looked at whether transplant outcomes with the newer organ donor sources have been maintained.
 

“The patients did as well as with other donor sources.”

RG: What did you find? 
Mehra: We found that most of the increase in organ donation has been due to organs recovered from victims of drug intoxication related deaths, reflecting the opioid crisis in the US. We found that this increase was particularly steep in the past four to five years, occurring in tandem with observed national trends in drug abuse. We also found that Europe did not appear to see this trend at all, suggesting that this crisis is uniquely occurring in the US.

RG: Does the use of opioid drugs have any negative impact on the donated organs? 
Mehra: We were unable to find a negative effect of drugs on the donor hearts and lungs recovered for transplantation. The patients did as well as with other donor sources.

RG: Did any of your results surprise you? 
Mehra: We were very surprised to learn that Europe did not have the drug epidemic crisis like we do in the US. We also were surprised that this donor source was based on a social ill, meaning that with policy changes it is largely not sustainable. On one hand, we are grateful that the drug crisis has positively impacted some lives, but we are sad that, in each instance, a potentially productive life had to be lost to save others with the transplanted organs.

“Once policies to address the opioid crisis become more entrenched, the organ source will diminish. Researchers must continue to develop new efforts to address organ shortages.”

RG: What do you hope doctors and researchers will take away from this study?
Mehra: First, we want doctors to not fear taking organs from this source. We also want the community to realize that once policies to address the opioid crisis become more entrenched, the organ source will diminish. Researchers must continue to develop new efforts to address organ shortages. These may include taking organs deemed to be marginal, finding new techniques for donors such as xenotransplantation, and even considering “printing” organs using 3-D printing technology.

RG: What do you hope patients and the public will take away? 
Mehra: Patients and the public can take some solace that the drug crisis at least yields a socially positive outcome with transplantation, in that one death can safe multiple lives through multi-organ donation. However, the drug crisis is a social evil that must be tackled rapidly with public policy.

The future of transplantation is bright, and while we applaud the increases in organ donation, we want to emphasize that we are saddened by the origin of this source. We hope that the public will continue to increase its donor organ awareness and remember that many lives can be saved by a single donor.