There appears to be a silver lining, if you want to call it that, to the epidemic of drug overdose deaths in the United States.
The surge in these fatalities has produced an increase in the number of organ donors.
According to the United Network for Organ Sharing (UNOS), in the first eight months of 2016, 791 out of 6,557 organ donors died due to drug intoxication.
While donors from drug deaths have increased steadily since 1994, there has been a notable increase in the past four years.
In 2015, and so far in 2016, more donors have died as a result of drug intoxication than gunshot wounds.
“The opioid crisis is a tragic situation which has had the unintended outcome of making more organs available for lifesaving transplants,” Alexandra Glazier, president and chief executive officer of New England Organ Bank, told Healthline.
In the New England area, the opioid crisis has increased the number of donors due to drug overdose from just eight people in 2010 (4 percent of organ donors that year) to 69 people (or 27 percent of organ donors) so far in 2016.
“The opioid crisis and its impact on donation underscores the importance of individuals making the decision to be a donor. The many who have said yes to donation are creating a lifesaving legacy of donation even in the face of this epidemic,” Glazier said.
No longer high risk
Traditionally, drug users had been considered “high risk” donors as many carry infections like hepatitis C or HIV.
However, there has been a shift in thinking about these donors in recent years.
Dr. David Klassen, the chief medical officer for UNOS, says in many cases the benefits of a patient accepting an organ from a “high risk” donor outweighs the risks.
“The actual risk is very low. A recipient’s survival is generally enhanced by receiving one of these organs relative to staying on the list and waiting for another organ,” Klassen told Healthline.
“New technology for screening of all donors allows much more sensitive screening to be done,” he added. “Safety can never be 100 percent, and patients and transplant surgeons must make their own assessment. I believe these donor organs are safe to use.”
In many circumstances, those who die from drug overdoses tend to be younger and otherwise in good health. This makes them good candidates for organ donation.
Recipients on the waiting list are told if they are offered an organ from a donor who is considered “high risk.” A patient won’t lose their place on the waiting list if they decide to decline the offer.
Although transmission of infections like hepatitis C through organ donation is possible, for some patients contracting such an infection could be the lesser of two evils.
“Hepatitis C is now curable with available treatments and HIV may be managed,” Glazier explains. “For many patients the risk of not receiving an organ and dying on the wait list is a bigger risk than the possibility of a transmission.”
The passage of the HIV Organ Policy Equity Act in 2013 reversed the ban on people with HIV donating their organs.
Earlier this year a team from Johns Hopkins Medicine performed the world’s first HIV-to-HIV liver transplant and the first HIV-to-HIV kidney transplant in the United States.
Experts from Johns Hopkins estimate that each year 500 to 600 people with HIV die. Their organs have the potential to save more than 1,000 people with HIV on the waiting list now that their organs can be used for transplant.
Still a shortage
Although changes in thinking toward donors who have HIV or have died of a drug overdose have opened up new possibilities in organ donation, the need for organs continues to exceed availability.
Almost 120,000 people in the United States are waiting for a lifesaving organ transplant.
On average, 22 people on the waiting list die every day and a new person is added to the list every 10 minutes. One organ donor has the potential to save eight lives.
“Each additional transplant means an additional life saved,” Glazier explains.
“The importance of this cannot be understated as the circle of impact is broad,” she added. “The patient, the patient’s family and friends, colleagues and community all benefit.”