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New research published in Critical Care, from Guy's and St Thomas' hospital in London, suggests that patients that die from drug overdoses or poisoning could donate their healthy organs to patients needing transplant operations. These findings could increase the number of organs available, saving the lives of people who die waiting for a transplant.
There is currently a global shortage of healthy organs available for transplant operations. In the UK alone approximately 5000 people are waiting for organ transplants. Most donated organs come from previously healthy young individuals that die of trauma, sudden cardiac death or brain injury. These cases are limited, so identifying other individuals who could act as organ donors save lives. Less than 1% of all organ donors are poisoned patients, even though research has shown that organs taken from this group can be successfully transplanted.
David Wood and colleagues from Guy's and St Thomas' Hospital in London, investigated whether poisoned patients represented a viable source of donor organs by conducting a survey of doctors from intensive care units (ICU) and transplantation centres. ICU doctors are responsible for suggesting patients that could be suitable organ donors, whilst the doctors at transplantation centres make the final decisions on which organs should be used.
Both groups of doctors were asked whether patients from four hypothetical scenarios should be candidates for donating a variety of organs. The scenarios included a cocaine overdose, a suicide from drinking methanol, cyanide poisoning and carbon monoxide poisoning.
The survey showed that 70% of transplant doctors would consider or accept organs from patients that had been poisoned with methanol, cyanide or carbon monoxide. However, only 50% of doctors would consider or accept organs from patients who overdosed on cocaine. The caution in accepting organs in this scenario was because there could be a greater risk of the organs being infected by HIV or hepatitis in drug users. The survey also showed that at least 80% of ICU doctors were willing to offer organs from poisoned patients to transplantation centres irrespective of the different poisoning scenarios.
The willingness shown in this study to accept organs from poisoned patients suggests that there is scope to expand the use of organs from patients who die from drug overdoses or poisoning. The authors concluded that, "Poisoned patients are another pool of organ donors, who at present are probably underused by transplantation services." They hope that increased awareness of the viability of organs from poisoned patients will help save the lives of patients who die each year waiting for an organ transplant.
This article is freely accessible online at: http://ccforum.com
Journal
Critical Care