Overdose deaths fuel surge in organ donations
Organ donations in Michigan and nationwide hit record numbers in 2017, due in part to the availability of life-saving hearts, kidneys, livers and other organs that came from people who overdosed on opioid drugs.
Organ donations can bring years — even decades — of life to their recipients because overdose victims are often younger than typical donors and have healthy organs despite their addictions.
When 33-year-old Ryan Anderson of Traverse City died of a drug overdose on Feb. 1, 2017, his mother, Laurie Anderson, and his family decided to donate his organs.
Nearly a year after Ryan’s death, she and four other family members met in January in Ann Arbor with his donor recipients, and she was able to hear her son’s heart beat through the chest of 64-year-old Peter Archangel of Northville. Joel Renauer of Temperance, 67, received his lungs, a 48-year-old woman received his liver, and his kidneys went to a 33-year-old woman and a 27-year-old man.
“It was very emotional, I was almost speechless,” Archangel said of the meeting. “She came and hugged me and wanted to hear the heart.
“It was about remembering Ryan, and honoring him. I tried to make her see that in her loss, Ryan goes on. There’s a connection still to Ryan, through me.”
Laurie Anderson noted her son’s “heart was huge.”
“He’d do anything for anyone,” she said. “While overdose deaths are common these days, no one wants to lose their child like that. …When they told me I could donate his organs, it was like this light appeared.”
Michigan had 320 organ donors in 2017, a 26 percent increase from 2014 when there were 254 donors, according to data released this week by Gift of Life Michigan, the state’s only federally designated organ and tissue recovery program. The number who died by drug overdose during the same period surged from 20 in 2014 to 51 last year, a 55 percent increase.
The proportion of the state’s organ donors who died by overdose surged from 1.6 percent in 2007 to 15.9 percent last year, according to Gift of Life Michigan.
“We want everyone to live a long and healthy life. We’re certainly not encouraged by the opioid crisis by any means,” said Dorrie Dils, CEO of Gift of Life Michigan. “It’s a tragedy. But deaths are going to occur, and we have the opportunity to take that tragedy and make it into something really amazing for someone else.”
The number of organ donors has increased in Michigan and across the country in recent years, according to the United Network for Organ Sharing, the nonprofit that manages organ sharing across the country. Overdose deaths are responsible for a large part of that increase, said Dr. David Klassen, chief medical officer with UNOS.
“We estimate that in the last few years it’s been about 40 percent (of the increase in donors) that can be traced back to the opioid epidemic,” Klassen said. “It’s clearly a substantial component of it, and it’s clearly the largest single identifiable area.”
The trend is expected to continue as nationwide drug overdose deaths soared to 66,972 during the 12-month period that ended in July, a 14.4 percent increase over the previous 12-month time period, according to provisional data from the federal Centers for Disease Control and Prevention.
Michigan had 2,376 drug-related deaths statewide in 2016, according to the Michigan Department of Health and Human Services. That was nearly a 20 percent increase over 2015, when 1,991 people died of drug overdoses.
Nationally, there were 16,473 organ donors in 2017, both living and deceased, according to UNOS data. The number of deceased donors hit an all-time high for the fifth year in a row with 10,287. Of those, about 13 percent or 1,371 donors died of drug intoxication. It compares with about 7 percent in 2014, when 625 of 8,596 donors died of overdoses.
New technologies have improved the certainty of disease detection, making more organs available for transplantation. At the same time, transplant centers and organ procurement organizations have improved procedures to ensure that nearly all potential donors or their families are given the opportunity to contribute.
Technology aids surge
In the past, organs from intravenous drug users were not considered for transplantation because addicts who share needles are at risk of contracting HIV or hepatitis C, said Klassen, a former medical director of the Kidney and Pancreas Transplant Programs at the University of Maryland Hospital.
Sensitive new screening technologies can detect most HIV and hepatitis C infections with a high degree of accuracy, with the exception of those contracted within a few days of the donor’s death. Because of that small window, IV drug users who die of overdose are classified as “increased risk” under CDC protocols, and the intended recipient must be notified.
“Those donors in the past were shied away from,” Klassen said. “Now, those can be used quite safely because of the ability to screen donors using some of the newer technologies. You can really do that with a lot of safety actually.
“If you look at actual rates of transmission from those donors, given the current screening, it’s very, very low. So I think most transplant surgeons would say that even for somebody who’s not (desperately) ill that is potentially a good donor.”
At Michigan Medicine in Ann Arbor, recipients often decide to accept an increased-risk organ when one is offered, said Dr. Daniel Kaul, professor of internal medicine and director of transplant infectious disease services.
People who overdose on drugs often die from respiratory arrest, which deprives the brain of oxygen needed to survive, Kaul added. But the heart, liver, kidneys and other organs typically survive intact and have the potential to give years of life to their recipients.
“In many cases, while it’s a tragic situation, they’re often younger people and they’re often quite healthy, so the organs can offer real hope for people who are awaiting transplant,” Kaul said.
Kaul said the risk of a recipient contracting hepatitis C from such an organ is about one in a thousand and even lower for HIV.
“Hepatitis C is curable after transplant,” Kaul said, noting the advent of new drugs to treat the liver disease. “With HIV, there are medications for it, and it is quite treatable.
“Waiting for an organ offer that may never come, people have to balance those risks. Our job is to counsel people as best we can, hopefully before the offer comes in the middle of the night.”
With 3,327 people on Michigan’s transplant waiting lists, and 114,997 waiting across the country, patients often die waiting for organs, said Dils of Gift of Life Michigan. People can sign up online to be a donor by visiting the Gift of Life Michigan Registry at www.golm.org.
“It’s important that people don’t assume that they can’t be donors because they’ve maybe been a drug user,” Dils said. “We evaluate each case individually, and we encourage everyone to sign up to be a donor in the registry.
“Sometimes an organ from a patient (who died of) an overdose is maybe the only organ that’s going to save their lives. It just speaks to the desperation of how badly people need organs.
“The reality is people are dying waiting for an organ transplant.”
Ryan Anderson’s lungs were given to Renauer of Temperance, whose birthday was Thursday. He celebrated it with a trip to Florida, the first time doctors have allowed him to travel since his transplant on Feb. 2, 2017.
Renauer didn’t hesitate to accept Ryan’s lungs after learning how the 33-year-old had died.
“To me, it doesn’t really matter. I know I’ve got good lungs,” Renauer said in a phone call from Florida. “I can walk the beach now.
“Last time I went to the beach I took my oxygen tank, went four or five feet, and said I’m not dragging this through the sand. Just that is enough for me to be thankful.”
Like Archangel, Renauer has met Laurie Anderson and Ryan’s other family members. He communicates with them regularly, and he plans to stay in touch for the rest of his life.
“I consider them part of my family now,” Renauer said. “I have her son’s lungs in me, so I know that they consider me part of their family, too.”
■Michigan has 3,327 patients on transplant waiting lists.
■To register as an organ donor, visit the Gift of Life at www.golm.org, and click the Sign Up Now button.
Rise in drug OD donors
The number and percentage of Michigan organ donors who die from drug intoxication or overdose has increased since 2007.
Source: Gift of Life Michigan