Numbers of deceased organ donors changed little from 2006 to 2010, with an average of 7486 donors per year, but have been increasing since 2010. In 2016, organs from 9389 deceased donors resulted in 26,564 transplants, 10.2% and 10.6% increases in donors and recipients, respectively, from 2015, and 26.3% and 23.6% increases, respectively, from 2010. The opioid epidemic has been speculated to be responsible for the increased numbers of deceased donors.

Using SRTR standard analytic files, we examined donor causes of death. We classified a death as a drug overdose if “drug intoxication” appeared in the mechanism of death field on the Organ Procurement and Transplantation Network Deceased Donor Registration form, or if free-form text specified drug overdose.

In 2016, 1208 deceased donors died of drug overdoses (12.9% of all donor deaths), compared with 331 (4.5%) in 2010 (Figure 1). Moreover, drug overdose deaths accounted for 45% of the total increase in donors, 2010-2016, and 54% of the increase 2015-2016. From 2010 to 2016, 541 (273% increase) more drug overdose deaths occurred among donors aged 18-34 years; 277 (298%) more, ages 35-49 years; and 52 (200%) more, ages 50-64 years. Increases in proportions of non-drug-overdose causes of death were less marked during the same period: 372 (19%) among donors aged 18-34 years; 282 (15%), ages 35-49 years; and 350 (18%), ages 50-64 years. Since 2010, 656 (70%) more cardiovascular deaths occurred, 179 (6.3%) fewer stroke deaths, 83 (4.8%) more trauma deaths, and 518 (33%) more other manners of death (including asphyxiation, gunshot wounds, and natural causes, all of which increased slightly).

Conclusion: Drug overdose deaths have increased considerably since 2010, but they are not solely responsible for the increase in deceased donors and subsequent increases in transplants in the US.

Figure 1: Manner of death, 2010-2016.

Figure 2: Drug overdose deaths by donor age, 2010-2016.

CITATION INFORMATION: Skeans M., Zaun D., Kasiske B. Causes of Death among Deceased Donors Am J Transplant. 2017;17 (suppl 3).

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