Introduction: The opioid epidemic disproportionately impacts different regions in the United States (US). Unfortunately, organ donations from drug overdose (DO) now account for a significant proportion of donors. This study seeks to understand the regional variation in donations after DO and quantify the proportion of DO deaths that go on to become organ donors in the US.
Materials and Methods: We analyzed data from the Organ Procurement and Transplantation Network (OPTN) as of November 10, 2017 that included deceased donors with DO as reported mechanism of death who donated at least one transplanted organ between January 1, 2000 and December 31, 2016. Only donors that had data from mechanism of death were reported. National mortality data was obtained from the National Center for Health Statistics from the Centers for Disease Control and Prevention (CDC) online mortality database.
Results & Discussion: Drug overdose has increased at an alarming rate; among those donors with a reported cause of death, DO accounted for 1.1% of donors in 2000 compared to 12.7% in 2016 (Figure 1). State age-adjusted mortality rates for DO in 2015 (from CDC data) correlate with OPTN regions with the highest percentage of donors from DO (Figures 2 and 3). However, high mortality rates do not correlate with the percentage of all DO deaths that become organ donors (Figure 4). Despite 28.2% of drug overdose deaths occurring in health care facilities in the US in 2015, only 1.62% become organ donors. The region with the highest percentage of deaths that become donors (2.36% Region 8 in the Midwestern US) has one of the lowest mortality rates; furthermore Region 8 had over two-fold the DO donation rate as Region 4 (1.03% in Texas/Oklahoma). A mean of 0.05 organs were transplanted for each drug overdose death in the US in 2015, a mean of 0.17 organs were transplanted for each overdose death in a medical facility.
Conclusion: The opioid epidemic is a serious and growing problem in the United States; perhaps the only silver lining in this tragic loss of life is the gift of organ donation. Though regions with the highest mortality from drug overdose have the largest proportion of donors, mortality rate does not correlate with the percentage of drug intoxication deaths that eventually become donors. More research is needed to understand the observed regional variation and barriers to maximizing donation after death from drug overdose.
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