Organ transplants in the US are on the rise, but the reason why means it’s not exactly a public health triumph

A life razed by drugs saves another through organ donation.
A life razed by drugs saves another through organ donation.
Image: AP Photo/Ebrahim Noroozi
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Organ transplants in the United States reached a record high for the fourth consecutive year.

In 2016, more than 33,600 organ transplants were performed in the US, according to preliminary data from the Organ Procurement and Transplantation Network (OPTN). The total number of transplants increased nearly 9% from the year prior and a whopping 20% since 2012, when around 28,000 transplants were performed.

The total number of deceased donors increased by 9.2% in 2016 compared to the year prior. Some of that is due to ”an ongoing commitment to improvement at organ procurement organizations, transplant hospitals, and the OPTN,” says Brian Shepard, head of the United Network of Organ Sharing (UNOS).

“Over the last several years we’ve had success using organs from donors with certain criteria we may not have accepted in the past,” UNOS chief medical officer David Klassen said in a statement—including those who died from heart or lung failure as opposed to brain death, those identified as having some increased risk for blood-borne disease, or those who succumbed to drug intoxication. Since the first successful kidney transplant in 1954, a lot has changed. Medics now make case-by-case evaluations of a patient’s medical and social history; for example, in 2016 researchers orchestrated a HIV-positive to HIV-positive liver and kidney transplant, which would have been deemed crazy just 20 years ago. In addition, “technology-driven improvements in the way organ donors are identified and recovered” have changed the equation in organ donation, according to Shephard. Now, portable transplant devices help keep organs alive outside the human body for longer. Other systems, such as XVIVO’s Lung Perfusion technology, allow doctors to evaluate and even treat lungs with “marginal functional injuries” outside the body.

The good news about organ donation cannot be separated from the dark shadow of drug abuse-related deaths. “The number of donors who died of overdoses increased over the past year,” Klassen told CNN. In 2015, a record 52,404 people died from a drug overdose, according to the Center for Disease Control. Most of these deaths can be attributed to America’s opioid epidemic: 20,101 overdose deaths were related to prescription pain relievers and 12,990 of them were related to heroin in 2015, according to the American Society of Addiction Medicine. In the New England region, which has seen a dramatic 900% increase in organ donations since 2016, more than a quarter of donors are now overdose victims.

This life-saving legacy of drug overdoses does not mark a win for public healthcare. In fact, now the state has two problems at hand: weaning drug abusers off their addiction and increasing the number of voluntary donors. Governments are working to make it easy and efficient for individuals getting or renewing licenses to register as donors. In August last year, New York allowed 16- and 17-year-olds to list themselves as donors. Families of unregistered people are also encouraged to make the decision to donate the organs of their loved ones after death. And change appears to be coming: in 2016, for the first time, the Gift of Life Donor Program for organ procurement in the eastern half of Pennsylvania, southern New Jersey, and Delaware received life-saving organs from more than 500 organ donors.

Across the US, 22 people die each day while waiting for an organ, and there are currently 119,053 people on the waiting list for transplants. The kidney is the most commonly transplanted organ in the last three decades, by far.