Goldberg D S, Blumberg E, McCauley M, Abt P, Levine M
Division of Gastroenterology, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Am J Transplant. 2016 Oct;16(10):2836-2841. doi: 10.1111/ajt.13971. Epub 2016 Aug 24.
Death rates from drug overdoses have nearly doubled since 2003, with over 47 000 deaths in 2014. This is largely attributable to the opioid epidemic. If the unfortunate deaths of otherwise healthy people have yielded an increase in organ donors, then this might serve as perhaps the only comforting factor among this tragic and unnecessary loss of life. In this viewpoint, we present data from the Organ Procurement and Transplantation Network (OPTN) that show how the greatest relative increases in the mechanism of death among deceased donors from 2003 to 2014 were drug overdoses. Unfortunately, despite the absolute increase in the number of donors who died from a drug overdose, the mean organ yield was significantly lower than in other categories, in part due to concerns about disease transmission. In this paper, we present data on the changes in donation from donors with a drug overdose as a result of the opioid epidemic and discuss the need to educate transplant candidates and their physicians about the low risk of disease transmission compared to the greater risk of dying on a transplant waitlist.
自2003年以来，药物过量导致的死亡率几乎翻了一番，2014年有超过47000人死亡。这在很大程度上归因于阿片类药物流行。如果原本健康的人的不幸死亡导致器官捐献者增加，那么这可能是这场悲惨且不必要的生命损失中唯一令人欣慰的因素。在这一观点中，我们展示了器官获取与移植网络（OPTN）的数据，这些数据表明2003年至2014年期间，已故捐献者中死亡机制相对增加最多的是药物过量。不幸的是，尽管死于药物过量的捐献者数量绝对增加了，但平均器官获取量明显低于其他类别，部分原因是担心疾病传播。在本文中，我们展示了因阿片类药物流行导致药物过量的捐献者的捐献变化数据，并讨论了有必要让移植候选者及其医生了解疾病传播风险较低，而在移植等待名单上死亡的风险更高。
