TY - JOUR
T1 - Impact of the Opioid Epidemic on Lung Transplantation
T2 - Donor, Recipient, and Discard Characteristics
AU - Phillips, Katherine G.
AU - Ward, Alison F.
AU - Ranganath, Neel K.
AU - Malas, Jad
AU - Lonze, Bonnie E.
AU - Moazami, Nader
AU - Angel, Luis F.
AU - Kon, Zachary N.
N1 - Publisher Copyright:
© 2019 The Society of Thoracic Surgeons
PY - 2019/11
Y1 - 2019/11
N2 - Background: The national opioid epidemic may have expanded the donor pool for lung transplant, but concerns remain regarding infectious risks and allograft function. This study compared donor and recipient characteristics, outcomes, and reasons for organ discard between overdose death donors (ODDs) and all other mechanism-of-death donors. Methods: Data on adult lung transplants from 2000 to 2017 were provided by the Scientific Registry of Transplant Recipients. Pulmonary allografts used in multiple organ transplants were excluded. Donor and recipient demographics, outcomes, and organ discard were analyzed with regards to ODDs since 2010. Discard analysis was limited to donors who had at least 1 organ transplanted but their pulmonary allografts discarded. Results: From 2010 to 2017, 7.3% of lung transplants (962/13,196) were from ODDs, over a 3-fold increase from the 2.1% (164/7969) in 2000 to 2007. ODDs were younger but more likely to have a history of smoking and hepatitis C or an abnormal bronchoscopy finding. Overall survival was similar between ODD and non-ODD groups. ODDs of discarded pulmonary allografts were younger and more likely to be hepatitis C positive but were less likely to have a history of smoking than their non-ODD counterparts. Conclusions: Rates of ODD use in lung transplant have increased in accordance with the opioid epidemic, but there remains a significant pool of ODD pulmonary allografts with favorable characteristics that are discarded. With no significant difference in survival between ODD and non-ODD recipients, further expansion of this donor pool may be appropriate, and pulmonary allografts should not be discarded based solely on ODD status.
AB - Background: The national opioid epidemic may have expanded the donor pool for lung transplant, but concerns remain regarding infectious risks and allograft function. This study compared donor and recipient characteristics, outcomes, and reasons for organ discard between overdose death donors (ODDs) and all other mechanism-of-death donors. Methods: Data on adult lung transplants from 2000 to 2017 were provided by the Scientific Registry of Transplant Recipients. Pulmonary allografts used in multiple organ transplants were excluded. Donor and recipient demographics, outcomes, and organ discard were analyzed with regards to ODDs since 2010. Discard analysis was limited to donors who had at least 1 organ transplanted but their pulmonary allografts discarded. Results: From 2010 to 2017, 7.3% of lung transplants (962/13,196) were from ODDs, over a 3-fold increase from the 2.1% (164/7969) in 2000 to 2007. ODDs were younger but more likely to have a history of smoking and hepatitis C or an abnormal bronchoscopy finding. Overall survival was similar between ODD and non-ODD groups. ODDs of discarded pulmonary allografts were younger and more likely to be hepatitis C positive but were less likely to have a history of smoking than their non-ODD counterparts. Conclusions: Rates of ODD use in lung transplant have increased in accordance with the opioid epidemic, but there remains a significant pool of ODD pulmonary allografts with favorable characteristics that are discarded. With no significant difference in survival between ODD and non-ODD recipients, further expansion of this donor pool may be appropriate, and pulmonary allografts should not be discarded based solely on ODD status.
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U2 - 10.1016/j.athoracsur.2019.05.065
DO - 10.1016/j.athoracsur.2019.05.065
M3 - Article
C2 - 31323210
AN - SCOPUS:85072713863
SN - 0003-4975
VL - 108
SP - 1464
EP - 1470
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 5
ER -