04 July 2023 : Original article
Drug Overdose and Cardiovascular Deaths Among Deceased Organ Donors: Implications for Donor Utilization and Data Reporting
Michie A. Adjei
1DEF, Steven A. Wisel2DE, Irene K. Kim2E, Justin A. Steggerda 2ABCDEF*
DOI: 10.12659/AOT.940255
Ann Transplant 2023; 28:e940255
Table 1 Selected characteristics of donors by expanded cause of death.
| Characteristics | Trauma (n=43,356) | Cardiovascular (n=20,053) | CVA/Stroke (n=44,707) | Drug untoxication (n=10,205) | Anoxia (NOS) (n=12,261) | Other/Unknown (n=2,200) | p-Value |
|---|---|---|---|---|---|---|---|
| Age (years) (median, IQR) | 28 (20–45) | 47 (34–56) | 52 (44–61) | 32 (26–42) | 29 (15–44) | 35 (19–48) | <0.001 |
| Gender, Female (n,%) | 10,722 (24.7%) | 9,513 (47.4%) | 22,921 (51.3%) | 4,346 (42.6%) | 5,016 (40.9%) | 1,048 (47.6%) | <0.001 |
| Body mass index (kg/m) | 25.2 (22.1–29.0) | 28.7 (24.2–34.3) | 27.4 (23.8–32.0) | 26.7 (23.5–31.1) | 24.4 (20.2–29.4) | 25.8 (21.0–31.0) | <0.001 |
| Race/ethnicity | <0.001 | ||||||
| White | 28,647 (66.1%) | 13,886 (69.3%) | 27,228 (60.9%) | 8,494 (83.2%) | 8,454 (69.0%) | 1,500 (68.2%) | |
| Black | 6,677 (15.4%) | 3,423 (17.1%) | 8,980 (20.1%) | 710 (7.0%) | 1,729 (14.1%) | 315 (14.3%) | |
| Hispanic | 6,982 (16.1%) | 2,221 (11.1%) | 6,487 (14.5%) | 842 (8.3%) | 1,663 (13.6%) | 314 (14.3%) | |
| Asian | 674 (1.6%) | 382 (1.9%) | 1,761 (3.9%) | 83 (0.8%) | 271 (2.2%) | 41 (1.9%) | |
| Other | 376 (0.9%) | 141 (0.7%) | 251 (0.6%) | 76 (0.7%) | 144 (1.2%) | 31 (1.4%) | |
| DCD Donor | 5,769 (13.3%) | 4,550 (22.7%) | 3,800 (8.5%) | 1,583 (15.5%) | 2,959 (24.1%) | 622 (28.4%) | <0.001 |
| Hypertension | 1,837 (4.3%) | 4,350 (21.9%) | 7,597 (17.1%) | 506 (5.0%) | 1,065 (8.7%) | 215 (9.9%) | <0.001 |
| Diabetes | 6,061 (14.1%) | 8,861 (44.5%) | 27,083 (61.0%) | 1,950 (19.2%) | 2,105 (17.3%) | 441 (20.3%) | <0.001 |
| Prior MI | 623 (1.4%) | 1,577 (7.9%) | 2,506 (5.6%) | 193 (1.9%) | 229 (1.9%) | 47 (2.2%) | <0.001 |
| Cancer | 635 (1.5%) | 617 (3.1%) | 2,015 (4.6%) | 126 (1.3%) | 203 (1.7%) | 197 (9.1%) | <0.001 |
| HCV-positive | 1,616 (3.7%) | 947 (4.7%) | 2,063 (4.6%) | 2,398 (23.5%) | 430 (3.5%) | 42 (1.9%) | <0.001 |
| # of comorbidities | <0.001 | ||||||
| 0 | 397 (0.9%) | 440 (2.2%) | 474 (1.1%) | 113 (1.1%) | 228 (1.9%) | 72 (3.3%) | |
| 1 | 30,829 (71.6%) | 8,233 (41.5%) | 15,470 (35.0%) | 6,092 (60.2%) | 8,511 (69.8%) | 1,294 (59.6%) | |
| 2 | 9,759 (22.7%) | 7,552 (38.0%) | 19,422 (43.9%) | 3,059 (30.2%) | 2,665 (21.9%) | 626 (28.8%) | |
| 3+ | 2,060 (4.8%) | 3,628 (18.3%) | 8,861 (20.0%) | 864 (8.5%) | 782 (6.4%) | 180 (8.3%) | |
| Heavy alcohol | 7,852 (18.1%) | 3,451 (17.2%) | 7,723 (17.3%) | 2,190 (21.5%) | 1,536 (12.5%) | 250 (11.4%) | <0.001 |
| Cigarette smoker | 7,038 (16.2%) | 6,119 (30.5%) | 13,970 (31.3%) | 2,357 (23.1%) | 1,920 (15.7%) | 362 (16.5%) | <0.001 |
| Any drug use | 18,835 (43.4%) | 7,586 (37.8%) | 12,423 (27.8%) | 8,894 (87.2%) | 4,451 (36.3%) | 593 (26.9%) | <0.001 |
| Creatinine >2.0 mg/dL | 3,985 (9.2%) | 5,449 (27.2%) | 7,143 (16.0%) | 2,552 (25.0%) | 1,912 (15.6%) | 222 (10.1%) | <0.001 |
| Bilirubin >2.0 mg/dL | 5,660 (13.1%) | 1,307 (6.5%) | 3,144 (7.1%) | 642 (6.3%) | 724 (5.9%) | 211 (9.7%) | <0.001 |
| AST >150 mg/dL | 5,977 (13.9%) | 4,511 (22.6%) | 2,548 (5.7%) | 2,602 (25.5%) | 2,650 (21.7%) | 213 (9.8%) | <0.001 |
| ALT >150 mg/dL | 3,965 (9.2%) | 3,830 (19.2%) | 1,987 (4.5%) | 3,148 (30.9%) | 2,582 (21.1%) | 195 (9.0%) | <0.001 |
| INR >1.5 | 10,081 (23.8%) | 3,842 (19.7%) | 8,438 (19.3%) | 2,041 (20.2%) | 2,655 (22.1%) | 461 (21.8%) | <0.001 |
| Sodium >150 mg/dL | 17,225 (39.8%) | 6,559 (32.7%) | 18,974 (42.5%) | 4,241 (41.6%) | 4,438 (36.3%) | 772 (35.4%) | <0.001 |