Effect of the opioid crisis on the liver transplantation donor pool: A national analysis
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Wiley
2024
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| author | Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik |
| author_facet | Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik |
| collection | Wiley Open Access |
| contents | Effect of the opioid crisis on the liver transplantation donor pool: A national analysis Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik Clinical Transplantation AbstractBackgroundOver the last decade there has been a surge in overdose deaths due to the opioid crisis. We sought to characterize the temporal change in overdose donor (OD) use in liver transplantation (LT), as well as associated post‐LT outcomes, relative to the COVID‐19 era.MethodsLT candidates and donors listed between January 2016 and September 2022 were identified from the Scientific Registry of Transplant Recipients database. Trends in LT donors and changes related to OD were assessed pre‐ versus post‐COVID‐19 (February 2020).ResultsBetween 2016 and 2022, most counties in the United States experienced an increase in overdose‐related deaths (n = 1284, 92.3%) with many counties (n = 458, 32.9%) having more than a doubling in drug overdose deaths. Concurrently, there was an 11.2% increase in overall donors, including a 41.7% increase in the number of donors who died from drug overdose. In pre‐COVID‐19 overdose was the 4th top mechanism of donor death, while in the post‐COVID‐19 era, overdose was the 2nd most common cause of donor death. OD was younger (OD: 35 yrs, IQR 29–43 vs. non‐OD: 43 yrs, IQR 31–56), had lower body mass index (≥35 kg/cm2, OD: 31.2% vs. non‐OD: 33.5%), and was more likely to be HCV+ (OD: 28.9% vs. non‐OD: 5.4%) with lower total bilirubin (≥1.1 mg/dL, OD: 12.9% vs. non‐OD: 20.1%) (all p < .001). Receipt of an OD was not associated with worse graft survival (HR .94, 95% CI .88–1.01, p = .09).ConclusionsOpioid deaths markedly increased following the COVID‐19 pandemic, substantially altering the LT donor pool in the United States. 10.1111/ctr.15290 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.15290 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_15290 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Effect of the opioid crisis on the liver transplantation donor pool: A national analysis Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik Clinical Transplantation Effect of the opioid crisis on the liver transplantation donor pool: A national analysis Yutaka Endo Kazunari Sasaki Muhammad Musaab Munir Selamawit Woldesenbet Diamantis I. Tsilimigras Erryk Katayama Jason Yang Ashley Limkemann Austin Schenk Kenneth Washburn Timothy M. Pawlik Clinical Transplantation AbstractBackgroundOver the last decade there has been a surge in overdose deaths due to the opioid crisis. We sought to characterize the temporal change in overdose donor (OD) use in liver transplantation (LT), as well as associated post‐LT outcomes, relative to the COVID‐19 era.MethodsLT candidates and donors listed between January 2016 and September 2022 were identified from the Scientific Registry of Transplant Recipients database. Trends in LT donors and changes related to OD were assessed pre‐ versus post‐COVID‐19 (February 2020).ResultsBetween 2016 and 2022, most counties in the United States experienced an increase in overdose‐related deaths (n = 1284, 92.3%) with many counties (n = 458, 32.9%) having more than a doubling in drug overdose deaths. Concurrently, there was an 11.2% increase in overall donors, including a 41.7% increase in the number of donors who died from drug overdose. In pre‐COVID‐19 overdose was the 4th top mechanism of donor death, while in the post‐COVID‐19 era, overdose was the 2nd most common cause of donor death. OD was younger (OD: 35 yrs, IQR 29–43 vs. non‐OD: 43 yrs, IQR 31–56), had lower body mass index (≥35 kg/cm2, OD: 31.2% vs. non‐OD: 33.5%), and was more likely to be HCV+ (OD: 28.9% vs. non‐OD: 5.4%) with lower total bilirubin (≥1.1 mg/dL, OD: 12.9% vs. non‐OD: 20.1%) (all p < .001). Receipt of an OD was not associated with worse graft survival (HR .94, 95% CI .88–1.01, p = .09).ConclusionsOpioid deaths markedly increased following the COVID‐19 pandemic, substantially altering the LT donor pool in the United States. 10.1111/ctr.15290 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Effect of the opioid crisis on the liver transplantation donor pool: A national analysis |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.15290 |