番茄社区

SAN DIEGO -- The growing number of donated lungs from people who died of opioid overdoses appear to fare as well as other donor lungs when they're accepted for transplants, a study found.

Opioid overdose death donors provided 7% of the transplanted lungs from 2010-2017, up from 2% in 2000-2007. There was no significant difference in overall survival between transplant recipients who received lungs from opioid overdose death donors and other donors (P=0.174).

The findings say nothing about discarded lungs from these deceased donors. Still, "the ones we're choosing aren't doing worse," and the study should spur discussions about whether more of these lungs should be used, said study co-author Neel Ranganath, MD, of NYU Langone Health in New York City.

The study findings were presented here at the .

For other organs too, the opioid epidemic is greatly boosting the number available for donation in the U.S.

However, Ranganath said, "while the opioid epidemic has contributed significantly to the organ donor pool, [the effect] has been less dramatic for lungs."

The findings concur with those of a recent suggesting that non-discarded organs do not pose any extra safety risk to transplant recipients, noted Mandeep Mehra, MD, of the Center for Advanced Heart Disease at Harvard Medical School in Boston, who led that 2018 study.

For the new study, Ranganath and colleagues examined lung transplant statistics for the years 2000-2017 from the Scientific Registry of Transplant Recipient, excluding organs used in multiple transplants and those from donors who suffered cardiac death.

Over the 2010-2017 period, opioid overdoses were the fourth-most common cause of death in deceased lung donors, following hemorrhage/stroke (36%), blunt injury (23%), and gunshot wound (17%).

The researchers also found that donors who died from opioid overdoses were significantly younger than other donors (median age 29 vs 36) and more likely to have hepatitis C (0.8% vs 0.1%). "They're also more likely to have a history of cigarette use and a more significant history of substance abuse," Ranganath said.

About 25% of discarded lungs from these donors were positive for hepatitis C compared with 5% of other donors (P<0.001).

"We should make every effort to not discard these organs," especially in light of the evolving treatment for hepatitis C, said Mehra, editor in chief of the Journal of Heart and Lung Transplantation. "In the past, we've been told as a transplant community that if someone has hepatitis C, walk away. Now we actually have very effective anti-hepatitis medication."

Further research into the quality of lungs from donors who died of opioid overdoses is warranted, Ranganath said, especially in light of the possibility that they're discarded for what he described as non-objective reasons. "Hopefully, it will show that more of these lungs can be used," he said.

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