The epidemic of drug overdose deaths in the United States has led to an increase in organ donors.

Dr Christine Durand and colleagues characterized donors who died of overdose, and analyzed outcomes among transplant recipients.

The researchers performed a prospective observational cohort study of Scientific Registry of Transplant Recipients between 2000 and 2017.

The team evluated 138,565 deceased donors, and 337,934 transplant recipients at 297 transplant centers.

The primary exposure was donor mechanism of death. 

Patient and graft survival and organ discard were compared using propensity score–weighted standardized risk differences.

A total of 7313 overdose-death donors, and 19,897 overdose-death donor transplants were identified. 

The team found that overdose-death donors accounted for 1% of donors in 2000 and 13% in 2017. 

They were more likely to be white, aged 21 to 40 years, infected with hepatitis C virus (HCV), and increased–infectious risk donors. 

Standardized 5-year patient survival was similar for overdose-death donor organ recipients compared with trauma-death donor organ recipients and medical-death donor organ recipients. 

Standardized 5-year graft survival was similar between overdose-death donor and trauma-death donor grafts. 

Dr Durand's team concludes, "In the United States, transplantation with overdose-death donor organs has increased dramatically, with noninferior outcomes in transplant recipients."

"Concerns about infectious risk donors behaviors and hepatitis C among donors lead to excess discard that should be minimized given the current organ shortage."