As Drug Deaths Soar, a Silver Lining for Transplant Patients (NYT)

[iolaire]

Most of my recent (non successful) calls have been in regards to drug users.


http://www.nytimes.com/2016/10/06/us/as-drug-deaths-soar-a-silver-lining-for-organ-transplant-patients.html
Start of story:
The surge in deaths from drug overdoses has become an unexpected lifeline for people waiting for organ transplants, turning tragedy for some into salvation for others.

As more people die from overdoses than ever before, their organs — donated in advance by them or after the fact by their families — are saving lives of people who might otherwise die waiting for a transplant.

When Dave and Roxanne Maleham got the call in June that they had long dreaded — that their son, Matt, 38, was on life support after overdosing on heroin and fentanyl — they talked about donating his organs.

“We were trying to think if we could draw any good out of this tragedy,” said Mr. Maleham, pastor at Union Congregational Church in Union, N.H.
Continue reading the main story 

Matt, as it turned out, had already registered as a donor on his driver’s license, which came as an enormous relief, almost a gift, to his parents. His donation reminded them of their son’s generosity and good-heartedness, qualities that his addiction had sometimes obscured.

“It absolutely turned things around for me,” Mrs. Maleham said. “Finding out that with his death someone else could benefit was such a joy.”

[iolaire]

Most of my recent (non successful) calls have been in regards to drug users.


http://www.nytimes.com/2016/10/06/us/as-drug-deaths-soar-a-silver-lining-for-organ-transplant-patients.html
Start of story:
The surge in deaths from drug overdoses has become an unexpected lifeline for people waiting for organ transplants, turning tragedy for some into salvation for others.

As more people die from overdoses than ever before, their organs — donated in advance by them or after the fact by their families — are saving lives of people who might otherwise die waiting for a transplant.

When Dave and Roxanne Maleham got the call in June that they had long dreaded — that their son, Matt, 38, was on life support after overdosing on heroin and fentanyl — they talked about donating his organs.

“We were trying to think if we could draw any good out of this tragedy,” said Mr. Maleham, pastor at Union Congregational Church in Union, N.H.
Continue reading the main story 

Matt, as it turned out, had already registered as a donor on his driver’s license, which came as an enormous relief, almost a gift, to his parents. His donation reminded them of their son’s generosity and good-heartedness, qualities that his addiction had sometimes obscured.

“It absolutely turned things around for me,” Mrs. Maleham said. “Finding out that with his death someone else could benefit was such a joy.”

Also this quote represents a lot of people, well we are more healthy we delay choices but know our view will change as our health slides. (Personally I'm healthy and ready for a high risk kidney, but I'm not ready for home HD yet.)

David Sellers, 51, who works with computers in Worcester, has been waiting for a kidney for a year. He is not yet on dialysis and says he is in fairly good shape, although exhausted at the end of the day.

“If I were presented tomorrow with a high-risk donor, I would opt not to accept it,” he said. “I don’t want to introduce another opportunity for disease to ravage my body.”

Still, he acknowledged that as his condition deteriorated, he might become more receptive to “whatever I could get.”

[kristina]

Thank you iolaire for this most interesting information.
... I have been wondering: If someone dies of a drug-overdose, does that not imply that they have been a regular user beforehand and does that not put the question what their regular (obviously heavy) drug-use has "done" to their organs over time ? ... And have their organs not been severely damaged over time because of their heavy drug-use ? ... And then the next logical question comes along : How safe are the donated organs of deceased overdosed drug-users? I am asking this, because it is so often reported in newspapers etc. why drug-users often need lots of money to pay for their drug-addiction and it is also regularly reported that their desperate need often leads them to "sell themselves" in order to pay for their addiction in any way they possibly can...
... Has there ever been any research done into how the donated organs of overdosed drug-users fare with transplant-receivers?
Thanks from Kristina.

[iolaire]

Thank you iolaire for this most interesting information.
... I have been wondering: If someone dies of a drug-overdose, does that not imply that they have been a regular user beforehand and does that not put the question what their regular (obviously heavy) drug-use has "done" to their organs over time ? ... And have their organs not been severely damaged over time because of their heavy drug-use ? ... And then the next logical question comes along : How safe are the donated organs of deceased overdosed drug-users? I am asking this, because it is so often reported in newspapers etc. why drug-users often need lots of money to pay for their drug-addiction and it is also regularly reported that their desperate need often leads them to "sell themselves" in order to pay for their addiction in any way they possibly can...
... Has there ever been any research done into how the donated organs of overdosed drug-users fare with transplant-receivers?
Thanks from Kristina.

The testing for infection is fairly good these days, there still is some odds that there was a very recent infection that doesn't show up but that is very low.  I'm not that worried about physically sick organs since the doctors should be doing tests before and after harvesting and have an idea of the quality of the offer.  I don't think drug use is similar to say a very heavy alcoholic and their liver.  Also most of these heroin OD donors are relatively young and healthily.  I'd expect the period of drug use is relatively short, those that have been long term users should know how to minimize the risk of OD'ing.

[Simon Dog]

The testing for infection is fairly good these days, there still is some odds that there was a very recent infection that doesn't show up but that is very low.

Google "nucleic acid testing" - they have the time to HIV detection down to a few days.

[kristina]

Many thanks iolaire and Simon Dog for your kind thoughts about testing for infection etc., it is very much appreciated.
I also had a chance to ask one of the nurses and she assured me that with drug-users, the kidney is "usually" the least affected organ
and their liver "usually goes first". The nurse also assured me that testing has been forwarded such a lot that these days it only takes a very short time...
Thanks again from Kristina.

[Rerun]

These drug overdoses are getting way too many way too often.

What to do.   

[iolaire]

These drug overdoses are getting way too many way too often.

What to do.   

I'm 40 and am surprised to see so many people from my home town that are about my age who are celebrating being a few years clean.  I don't know exactly the drugs (and alcohol) use they are recovering from but it must have been a hard life to be getting yourself in order in the late 30's...  I do like how voice they are about getting clean because their affirmations might be just the thing needed for someone else to make the same choice.

[kickingandscreaming]

I recommend watching PBS Frontline's "The Choice." It is a study of both candidates tracing their development to this moment.  It streams for free at:
http://player.pbs.org/viralplayer/2365848966  But it won't be available forever.

[Simon Dog]

Many thanks iolaire and Simon Dog for your kind thoughts about testing for infection etc., it is very much appreciated.
I also had a chance to ask one of the nurses and she assured me that with drug-users, the kidney is "usually" the least affected organ
and their liver "usually goes first". The nurse also assured me that testing has been forwarded such a lot that these days it only takes a very short time...
Thanks again from Kristina.

You hit on the two issues: Infection (HIV, Hep-C) and "beat uppedness of the organ".   As to the former - all organs get infected at once.  The later takes time.

I was shocked when the transplant director told me "Hep-C can be cured now and HIV can be controlled" as if having a "controlled HIV infection" was not a big deal.  My nephs reaction was "ah, no...." when I mentioned that.

[jmintuck]

The testing for infection is fairly good these days, there still is some odds that there was a very recent infection that doesn't show up but that is very low.

Google "nucleic acid testing" - they have the time to HIV detection down to a few days.

I didn't see that one coming. OYE VAY!
 
But the drug OD patients would be slightly unnerving. I hear stories of "Organ Memory", a syndrome brought on by donated organs that cause people to crave things they CERTAINLY hated, or even abhorred. Could it even lead to a new incidence of drug addiction? That is what I would worry about.