Opioid overdose donors: their impact on lung transplantation
The unfortunate epidemic of opioid overdose death donors (ODDs) over the last decade has prompted a New York group(4) to investigate the impact of this relatively recent surge in new donors on outcomes after lung transplantation.
The authors compared two successive periods: 2000 to 2007 (when only 2.1% of donated lungs were derived from opioid overdose donors) and 2010 to 2017 (when this proportion rose to 7.3% (a three-fold increase)). Donor/recipient demographics, outcomes and organ discard were analyzed with regards to ODDs since 2010.
Although ODDs were younger and more likely to have a history of smoking, hepatitis C or an abnormal bronchoscopy finding, the authors found no significant difference in overall survival between ODD and non-ODD groups.
While the increase in ODD utilization in lung transplantation has generally reflected the opioid epidemic, the authors believe there remains a significant pool of ODD pulmonary allografts with favorable characteristics that are discarded. These results suggest that donor lungs should not be discarded based solely on ODD status.
References:
4. Phillips KG, et al, Impact of the Opioid Epidemic on Lung Transplantation: Donor, Recipient and Discard Characteristics. Ann Thorac Surg. 2019 Jul 16. pii: S0003-4975(19)31026-4 (link to abstract)
Xvivo Insights PB-2019-10-13
