Hearts from Drug Users Safe for Transplant, Confirms Study

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Heart transplant
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Two recently published studies have found that hearts from drug users or those who died of overdose are safe for transplants.

Over the years, the number of annual heart transplants has steadily increased in the United States. In 2019 alone, the US reported a total of 3,552 heart transplants, the highest number to date. Despite the increasing number of transplants, the number of people on the waiting list has also grown. Moreover, the opioid crisis has led to an increase in the availability of the organ. However, hearts from drug users or those who have died from an overdose are not routinely used for transplants and go to waste.

Approximately 20% of people on the waitlist die or become ‘too sick’ to undergo a transplant. Now two recently published studies suggest that the post-transplant survival rate is unaffected by the donor’s drug use or whether they died from a drug overdose. Thus, likely leading to an increase in the availability of hearts and reducing the percentage of people that die waiting for a transplant.

These findings should encourage institutions who are not routinely using hearts from drug users to do so. It will reduce the waiting time and the number of deaths among people on the heart transplant waitlist.

Dr. Howard Eisen, chair of the American Heart Association’s Heart Failure and Transplantation Committee of the Clinical Cardiology Council

Once High Risk, Now Safe

Titled ‘Intoxicated Donors and Heart Transplant Outcomes: Long Term Safety’, it is the largest study to investigate drug use in heart transplant donors. And the only study that examined toxicology data at the time of organ donation. The research looked at data from 2007 to 2017. It aimed to compare survival rates among heart transplant patients who received a heart from drug users and those who did not. Moreover, they identified the type of illicit drugs the donors used. According to lead study author David A. Baran, the post-transplant rate was unaffected by the donor’s drug use. Nor did the presence of multiple drugs in the toxicology reports of donors affect post-transplant mortality.

The second study looked at donors with a history of drug use and those with hepatitis C. They analyzed data from 2008 to 2012 and 2013 to 2017 and compared them with 2003 to 2007. Results showed that compared to earlier years, donors in 2013-2017 weighed more, had more comorbids, had higher drug use and were older. However, they had lower post-transplant deaths than the donors from 2003-2007. Moreover, the donors’ hepatitis C status did not affect the survival rates either.

We hope that patients who are awaiting transplants are encouraged to accept hearts from donors who had hepatitis C or who died due to a drug overdose, if their health care team finds the donor heart to be an appropriate match.

Dr. Ravi Dhingra, lead study author

Therefore, both these studies add to the evidence of hearts from drug users being safe for transplantation.

Reference:

Dharmavaram, Naga, et al. “National Trends in Heart Donor Usage Rates: Are We Efficiently Transplanting More Hearts?” Journal of the American Heart Association, vol. 10, no. 15, 2021, doi:10.1161/jaha.120.019655.

Baran, David A., et al. “Intoxicated Donors and Heart Transplant Outcomes: Long-Term Safety.” Circulation: Heart Failure, 2021, doi:10.1161/circheartfailure.120.007433.

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