Impact of the Opioid Epidemic on Lung Transplantation: Donor, Recipient, and Discard Characteristics

Katherine G. Phillips, Alison F. Ward, Neel K. Ranganath, Jad Malas, Bonnie E. Lonze, Nader Moazami, Luis F. Angel, Zachary N. Kon

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1464-1470
Number of pages7
JournalAnnals of Thoracic Surgery
Volume108
Issue number5
DOIs
StatePublished - Nov 2019
Externally publishedYes

Fingerprint

Lung Transplantation
Opioid Analgesics
Tissue Donors
Lung
Allografts
Transplants
Hepatitis C
Smoking
Survival

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Phillips, K. G., Ward, A. F., Ranganath, N. K., Malas, J., Lonze, B. E., Moazami, N., ... Kon, Z. N. (2019). Impact of the Opioid Epidemic on Lung Transplantation: Donor, Recipient, and Discard Characteristics. Annals of Thoracic Surgery, 108(5), 1464-1470. https://doi.org/10.1016/j.athoracsur.2019.05.065

Impact of the Opioid Epidemic on Lung Transplantation : Donor, Recipient, and Discard Characteristics. / Phillips, Katherine G.; Ward, Alison F.; Ranganath, Neel K.; Malas, Jad; Lonze, Bonnie E.; Moazami, Nader; Angel, Luis F.; Kon, Zachary N.

In: Annals of Thoracic Surgery, Vol. 108, No. 5, 11.2019, p. 1464-1470.

Research output: Contribution to journalArticle

Phillips, KG, Ward, AF, Ranganath, NK, Malas, J, Lonze, BE, Moazami, N, Angel, LF & Kon, ZN 2019, 'Impact of the Opioid Epidemic on Lung Transplantation: Donor, Recipient, and Discard Characteristics', Annals of Thoracic Surgery, vol. 108, no. 5, pp. 1464-1470. https://doi.org/10.1016/j.athoracsur.2019.05.065
Phillips, Katherine G. ; Ward, Alison F. ; Ranganath, Neel K. ; Malas, Jad ; Lonze, Bonnie E. ; Moazami, Nader ; Angel, Luis F. ; Kon, Zachary N. / Impact of the Opioid Epidemic on Lung Transplantation : Donor, Recipient, and Discard Characteristics. In: Annals of Thoracic Surgery. 2019 ; Vol. 108, No. 5. pp. 1464-1470.
@article{3088f4aa0f1341d880eed5604696963c,
title = "Impact of the Opioid Epidemic on Lung Transplantation: Donor, Recipient, and Discard Characteristics",
abstract = "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.",
author = "Phillips, {Katherine G.} and Ward, {Alison F.} and Ranganath, {Neel K.} and Jad Malas and Lonze, {Bonnie E.} and Nader Moazami and Angel, {Luis F.} and Kon, {Zachary N.}",
year = "2019",
month = "11",
doi = "10.1016/j.athoracsur.2019.05.065",
language = "English (US)",
volume = "108",
pages = "1464--1470",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

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.

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.

UR - http://www.scopus.com/inward/record.url?scp=85072713863&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072713863&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2019.05.065

DO - 10.1016/j.athoracsur.2019.05.065

M3 - Article

C2 - 31323210

AN - SCOPUS:85072713863

VL - 108

SP - 1464

EP - 1470

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -