Numbers of deceased organ donors have increased steadily since 2012, with large increases 2015-2016. The opioid epidemic has been speculated to drive these increases, differentially across the US.

Using SRTR data, we examined causes of death among donors in 2012 and 2016. We classified a death as a drug overdose if "drug intoxication" appeared in the mechanism of death field on the OPTN Deceased Donor Registration form, or if text specified drug overdose. We examined changes in numbers and proportions of OD deaths by donation service area (DSA) and OPTN region.

From 2012 to 2016, numbers of deceased donors increased in all regions, from 61 (10.7%) more donors in region 8 to 344 (49.9%) more in region 4 (Figure 1). Nationally, numbers of deaths due to drug overdoses increased substantially, from 420 (5.5%) donors in 2012 to 1208 (12.9%) in 2016. Increases in numbers and proportions occurred in all OPTN regions, but not equally. In 2012, in region 1, New England, the number of drug overdose deaths more than tripled, with 30 (12.4%) in 2012 and 96 (26.2%) in 2016. In region 2 (PA, NJ, DE, RI, MD, and WV), drug overdose deaths also tripled, from 80 (8.7%) in 2012 to 262 (22.2%) in 2016. In region 4, TX and OK, the overall increase in donors was largest (344), but the proportion of drug overdose deaths was lowest, 3.3% (23) and 4.3% (44), in 2012 and 2016, respectively. Even that relatively modest increase reflects twice as many overdose deaths. In regions 5 and 6, encompassing the entire West Coast, increases were similar to each other, from 4.4% in 2012 to 8.4% in 2016. In 2012, in 17 of 58 DSAs, less than 3.8% of donors died of drug overdoses, and more than 13.3% in 3 DSAs. By 2016, less than 3.8% of donors died of drug overdoses in only 6 DSAs, and more than 13.3% in 29 DSAs (Figure 2).

Donor deaths due to drug overdoses increased from 2012 to 2016, with large increases in the Northeast and smaller increases on the West Coast and in Texas.

CITATION INFORMATION: Skeans M., Zaun D., Kasiske B. Geographic Variation in Drug Overdose as Donor Cause of Death Am J Transplant. 2017;17 (suppl 3).

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