The opioid epidemic is fueling an increase in the proportion of deceased organ donors categorized as posing a high risk of transmitting HIV or hepatitis B or C viruses (HBV/HCV) to a transplant recipient. Such individuals are known as increased risk donors (IRDs), as opposed to standard risk donors (SRDs).
Publishing their findings in the Morbidity and Mortality Weekly report, Centers for Disease Control and Prevention (CDC) researchers analyzed 2010 to 2017 data reported to the Organ Procurement and Transplantation Network.
The annual number of deceased donors increased by 29.5 percent between 2010 and 2017, from 7,943 to 10,287. Out of the 70,414 deceased donors during this period, 57,782 (82.1 percent) were classified as SRDs, 12,592 (17.9 percent) as IRDs and 40 (less than 0.1 percent) as an unknown risk. The average donor age was 39.9 years old, 59.6 percent were male and 66.2 percent were white.
During the study period, the proportion of deceased donors classified each year as IRDs increased about 3-fold, from 8.9 percent in 2010 to 26.3 percent in 2017. The proportion with drug intoxication reported as the cause of death increased by about 3-fold, from 4.3 percent to 13.4 percent. And the proportion of donors who had a history of injection drug use increased about 6-fold, from 1.3 percent to 8 percent.
In keeping with trends among those who die of opioid overdose in the United States, people classified as IRDs, compared with those listed as SRDs, were more commonly white, male and between 25 and 34 years old. Compared with SRDs, IRDs had a higher rate of chronic HCV infections and a higher number and rate of acute HCV infections. (An acute HCV infection would test negative for antibodies to the virus but positive for HCV RNA.) IRDs also had a higher rate of HBV compared with SRDs.
“These findings demonstrate the continuing need for identifying viral bloodborne pathogen infection risk factors among deceased donors to reduce the risk for transmission, monitor posttransplant infection in recipients, and offer treatment if infection occurs,” the study authors reported.
Meanwhile, physicians have blazed a new frontier in medicine by transplanting HCV-infected organs to HCV-negative recipients, who then can be safely and successfully treated for the virus after transplantation.
To read the CDC report, click here.