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More organs available for heart transplants from opioid epidemic

Source/Disclosures Source: Phillips KG, et al. Ann Thorac Surg. 2019;doi:10.1016/j.athoracsur.2019.03.076. ADD TOPIC TO EMAIL ALERTS Receive an email when new articles are posted on . Please provide your email address to receive an email when new articles are posted on Subscribe ADDED TO EMAIL ALERTS You've successfully added to your alerts. You will receive an email when new content is published.



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Nader Moazami



The opioid epidemic has played a role in the increase of organ donations from patients who died from an overdose, but they provided favorable cardiac allografts despite the increased rate of hepatitis C in these patients, according to a study published in The Annals of Thoracic Surgery.

“There has been an increase in transplantation because of the opioid epidemic consistent with the increase rate of death from opioids,” Nader Moazami, MD, professor in the department of cardiothoracic surgery and surgical director of heart transplantation and mechanical circulatory support at NYU Langone Health, told Cardiology Today. “Hearts transplanted from these donors are suitable with comparable survival compared to other donors. Many more potentially suitable hearts are discarded, but our data suggest they should be used if selected appropriately, including hearts from donors with active hepatitis C.”

Transplantation data

Katherine G. Phillips, BS, research assistant at NYU Langone Health and undergraduate researcher at the Butcher Lab at Cornell University, and colleagues analyzed data from the Scientific Registry of Transplant Recipients of 15,904 cardiac transplantations with adult donors from 2010 to 2017. Both donor and recipient characteristics were assessed, in addition to organ discard.

Of the transplantations in the study, 10.8% were performed with cardiac allografts from donors who died from an overdose, which was a nearly 10-fold increase from 1.2% in 2000.

Organ donors who died from an overdose were typically older than 40 years (87.2% vs. 70.1%; P < .001), more likely to be HCV-positive (1.3% vs. 0.2%; P < .001) and had higher rates of substance abuse compared with those who did not die of an overdose. Inotropic support was less frequently received by organ donors who died from an overdose at the time of procurement (38.4% vs. 44.8%; P < .001).

The opioid epidemic has played a role in the increase of organ donations from patients who died from an overdose, but they provided favorable cardiac allografts despite the increased rate of hepatitis C in these patients, according to a study published in The Annals of Thoracic Surgery. Source: Adobe Stock

Patients who received organs from either group had similar rates of unadjusted overall survival (P = .066).

Compared with donors who did not die of an overdose, discarded allografts from donors who died from an overdose were more likely to have increased risk according to the Public Health Services (63.3% vs. 13.2%; P < .001) and more likely to be HCV-positive (30.8% vs. 5.3%; P < .001). Despite this, organs from donors who died from an overdose were less likely to be discarded because of a diseased organ state (28.2% vs. 36.1%; P < .001).

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Further research

“[We need more research on] what organs are not used despite the donor’s wishes, why specifically (we need more granularity as this is all retrospective data) and can we further increase transplantation by being more creative in organ preservation from these donors,” Moazami said in an interview. “Unfortunately, given the large number of deaths occurring from this tragedy, despite donors’ wishes, many organs are not being used.” – by Darlene Dobkowski

For more information:

Nader Moazami, MD, can be reached at Department of Cardiothoracic Surgery, NYU Langone Health, 530 First Ave., Suite 9V, New York, NY 10016; email: nader.moazami@nyulangone.org.

Disclosures: The authors report no relevant financial disclosures.