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Overdose-Death Donor Hearts Suitable for Transplant

Proportion of cardiac transplantations from ODDs increased; no difference seen in terms of overall survival

THURSDAY, June 6, 2019 (HealthDay News) — Recipient overall survival is similar for overdose-death donor (ODD) and non-ODD cardiac transplants, according to a study published online June 6 in the Annals of Thoracic Surgery.

Katherine G. Phillips, from New York University Langone Health in New York City, and colleagues examined recipient and donor characteristics and organ discard with respect to ODDs and donors with other mechanisms of death using data on adult cardiac transplants from 2010 to 2017.

The researchers found that 10.8 percent of the 15,904 cardiac transplantations were from ODDs, representing about a 10-fold increase from 1.2 percent in 2000. ODDs were more often older than 40 years (87.2 versus 70.1 percent), had higher rates of substance abuse, were more likely to be hepatitis C-positive (1.3 versus 0.2 percent), and less often required inotropic support at procurement (38.4 versus 44.8 percent). The groups did not differ in terms of overall survival. Discarded ODD allografts were less likely to be discarded because of a diseased organ state (28.2 versus 36.1 percent), but they were more likely to be hepatitis C-positive (30.8 versus 5.3 percent) and to be identified as conveying an increased risk by the Public Health Services (63.3 versus 13.2 percent).

“We do not believe that overdose status alone is a valid reason to discard an otherwise viable donor heart, and this study supports that ODD organs should not be rejected due to inappropriate bias,” a coauthor said in a statement.

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