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Safe Transplantation Includes Heart From Illicit Drug Use Donors

According to new studies published in the American Heart Association’s scientific journals, the survival rates of heart recipients do not affect if they receive hearts from the donors who died because of illicit drug use.

According to the American Heart Association’s 2021 Heart Disease and Stroke Statistical Update, 52 people are on the waiting list for the lung and a heart transplant and 3661 people are waiting list for a heart transplant. This data was recorded on 11 March 2020. The highest number of heart transplants have been recorded in the US in 2019 with a total of 3552 transplantations. Basically, the reason for a heart transplant is the improper functioning of one or both ventricles or severe heart failure. So, during a transplant, a person’s heart is replaced with a healthy heart. 

Safe Transplantation Includes Heart From Illicit Drug Use Donors

Howard Eisen, M.D., chair of the American Heart Association’s Heart failure and Transplantation Committee of the Clinical Cardiology Council believes that according to data of 2019 people with addiction problems and drugs can donate a heart to the recipient without any drawbacks. He was not, however, a participant in the research. He further added that the study helped much for the institutions which are not allowing drug users to donate a heart. Thus, it will prevent further deaths of the patients on the waiting list.

Safe Transplantation Includes Heart From Illicit Drug Use Donors

David A. Baran, lead study author of the “Intoxicated Donors and Heart Transplant Outcomes: Long Term Safety” and system director for advanced heart failure and transplantation at Sentara Heart Hospital in Norfolk, Virginia has explained that many hearts are unused because of the donor’s drug use problems which could reduce the patient’s survival chance. However, many heart donations have been made due to the opioid epidemic.

Baran and his colleagues have reviewed the data from the United Network for Organ Sharing Database for the study of drug use of heart transplant donors and analysis of toxic data of drug users. UNOS keeps records of all the heart transplants like recipients and donors information and drug use of donors. The study includes more than 23,000 adults who are drug users and heart transplant recipients and data were observed from January 1, 2001, to December 31, 2017.  

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During the analysis, the average age of recipients was 53 and the donor was 32. Researchers also try to identify the type of drugs the donors were using like opioids, cocaine, marijuana, etc from the urine tests of the donors in hospital records. 

Barren and his colleagues observed that the recipients who received hearts from donors who do not use drugs were comparable to the recipients who received hearts from a drug use donor. 

He concluded that hospitals should not reject a donor even if he uses more than one illicit drug.

The study has one major limitation that it includes the heart which was accepted for the transplantation. Other results submitted by local laboratories may be wrong as there is no central laboratory, administration of opioids can be misleading or errors while entering the information in the database. 

Ravi Dhingra, M.D., M.P.H., medical director of the heart failure and transplant program and associate professor of medicine at the University of Wisconsin-Madison, is the primary study author. Patients should be encouraged and ready to accept hearts from donors who died as a result of drug issues or hepatitis C, he said. He further added that 20% of heart recipients die while waiting for the transplantation. He and his colleagues thought if the donor’s list could include patients with Hepatitis C as it is a viral liver infection and can be treated by antiviral medications so that it will widen the donor pool. 

He and his colleagues have taken data from the UNOS database for the comparison of the total number of hearts accepted or rejected for transplantation from 1995 to 2018. In this study, they compared the number of survivors of heart transplantation who received a heart from the donors who died from a drug overdose or hepatitis C and survivors who received a heart from the donors who have not used drugs or had hepatitis C. 

In the study, they found that heart donors weighed more and were likely to have high blood pressure and diabetes and used drugs which increased the risk of hepatitis C in 2013-2017 as compared to 2003-2007. Although, the risk of death was 15% lower after one month and 21% after one year in 2013-2017 recipients compared with 2003-2007 data. The study also included risk factors affecting recipients’ survival. 

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