Increase in drug overdose donors led to steady transplant volume during COVID-19
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SAN DIEGO — An increase in drug overdose donor utilization during the COVID-19 pandemic contributed to a steady transplant volume among all organ types, including liver transplants, according to a presenter at Digestive Disease Week 2022.
“The continued pervasiveness of the opioid epidemic has led to the increased utilization of young, otherwise healthy [drug overdose donors (DODs)],” Peter Lymberopoulos, MD, of St. George's University School of Medicine in San Jose, California, said during the presentation. “DOD utilization surged during the COVID-19 pandemic and contributed to the increasing transplant volume seen in all organ types, including [liver transplant (LT)]. Although the volume of liver donors from all other causes remained relatively stable during the pandemic, an increase in numbers of liver grafts from DOD contributed to LT volume increasing to new heights.”
Lymberopoulos and colleagues used the United Network for Organ Sharing (UNOS) registry to assess all adult recipients who underwent solid organ transplantation, including LT, in the United States from January 2017 to June 2021. They defined the pre-COVID period from January 1, 2019, to February 29, 2020, and the COVID period from May 1, 2020, to June 30, 2021. The UNOS variable that characterizes the mechanism of death of the donor was used to identify DODs. Demographic information and clinical characteristics of DODs from the pre-COVID and COVID periods were compared with tests of proportions and unpaired T-tests.
According to study results, the number of donors for all solid organ transplantation remained stable in both pre-COVID and COVID periods (14,029 vs. 15,547), as did the number of LTs (9,687 vs. 10,096), demonstrated by a rise of DOD use.
In addition, utilization of DODs for solid organ transplantation from the pre-COVID to COVID periods increased 33% from 13.7% (n = 1,924) to 16.4% (n = 2,553) and was seen across all organ types, especially LT (pre-COVID n = 1,465, 15.1% vs. COVID n = 1,846, 18.3%; P < .001). In the COVID period, the percentage of young adult donors younger than 30 years decreased among DODs (31.2% vs. 28%; P = .022).
Further, Lymberopoulos and colleagues observed the percentage of DODs with hepatitis C virus seropositivity decrease by 5.2% (34.3% vs. 29.1%; P < 0.001) and 4.3% in HCV viremias (22.1% vs. 17.8%; P < 0.001). They noted a significant increase in DOD utilization in the South and Midwest.
“The transplant community has experienced continued success despite the significant challenges faced during the pandemic,” Lymberopoulos said. “Nevertheless, it might come with a great cost to the youth of our nation, as the COVID-19 pandemic has exacerbated a universal trend in opioid-related death throughout the United States.
“Further studies are urgently needed to address this concerning trend and to guide future strategies to stop the aggravated opioid endemic during the COVID-19 pandemic.”
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Lymberopoulos M, et al. Poster Su1373. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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