Donald F Chute1, Meghan E Sise2. 1. Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA. 2. Division of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Abstract
BACKGROUND: The opioid crisis has led to a dramatic increase in the number of drug overdose deaths in the United States. Little is known about the effect of the opioid crisis on the kidney transplant donor pool, particularly on hepatitis C virus (HCV)-infected donors. METHODS: This is a retrospective analysis of the data from the Organ Procurement and Transplantation Network from 2010 to 2016. We determined the changes in characteristics of kidney transplant donors and evaluated which changes may be directly related to the opioid crisis. RESULTS: Between 2010 and 2016, we found a 26% increase in overall donors, including a 277% increase in the number of donors who died from drug overdose. Nineteen percent of donors who died of drug overdose had HCV infection. Donors who die from drug overdose and donors with HCV infection are younger, less likely to have diabetes or hypertension, and have favorable kidney donor profile index scores compared to average donors. Despite these favorable characteristics, HCV-infected donors appear to be notably underutilized, with substantially lower kidneys per donor being transplanted compared to HCV uninfected donors. CONCLUSION: The opioid crisis in the United States has substantially altered the kidney donor pool. Strategies to increase utilization of all potentially viable kidneys for transplant are needed, particularly in this era of new, highly effective, direct-acting antiviral therapy for HCV infection.
BACKGROUND: The opioid crisis has led to a dramatic increase in the number of drug overdose deaths in the United States. Little is known about the effect of the opioid crisis on the kidney transplant donor pool, particularly on hepatitis C virus (HCV)-infected donors. METHODS: This is a retrospective analysis of the data from the Organ Procurement and Transplantation Network from 2010 to 2016. We determined the changes in characteristics of kidney transplant donors and evaluated which changes may be directly related to the opioid crisis. RESULTS: Between 2010 and 2016, we found a 26% increase in overall donors, including a 277% increase in the number of donors who died from drug overdose. Nineteen percent of donors who died of drug overdose had HCV infection. Donors who die from drug overdose and donors with HCV infection are younger, less likely to have diabetes or hypertension, and have favorable kidney donor profile index scores compared to average donors. Despite these favorable characteristics, HCV-infected donors appear to be notably underutilized, with substantially lower kidneys per donor being transplanted compared to HCV uninfected donors. CONCLUSION: The opioid crisis in the United States has substantially altered the kidney donor pool. Strategies to increase utilization of all potentially viable kidneys for transplant are needed, particularly in this era of new, highly effective, direct-acting antiviral therapy for HCV infection.
Authors: Sarah E Van Pilsum Rasmussen; Shanti Seaman; Diane Brown; Niraj Desai; Mark Sulkowski; Dorry L Segev; Christine M Durand; Jeremy Sugarman Journal: AJOB Empir Bioeth Date: 2019-10-16
Authors: Meghan E Sise; Ian A Strohbehn; Emily Bethea; Jenna L Gustafson; Raymond T Chung Journal: Curr Opin Organ Transplant Date: 2019-06 Impact factor: 2.640
Authors: Meghan E Sise; David S Goldberg; Jens J Kort; Douglas E Schaubel; Rita R Alloway; Christine M Durand; Robert J Fontana; Robert S Brown; John J Friedewald; Stacey Prenner; J Richard Landis; Melissa Fernando; Caitlin C Phillips; E Steve Woodle; Adele Rike-Shields; Kenneth E Sherman; Nahel Elias; Winfred W Williams; Jenna L Gustafson; Niraj M Desai; Brittany Barnaba; Silas P Norman; Mona Doshi; Samuel T Sultan; Meredith J Aull; Josh Levitsky; Dianne S Belshe; Raymond T Chung; Peter P Reese Journal: J Am Soc Nephrol Date: 2020-08-25 Impact factor: 10.121
Authors: Andrew A Li; George Cholankeril; Xingxing S Cheng; Jane C Tan; Donghee Kim; Alice E Toll; Satheesh Nair; Aijaz Ahmed Journal: Diseases Date: 2018-07-10