Donor hearts from illicit drug users safe, research finds

Receiving a heart transplant from a donor who used illicit drugs doesn't affect the recipient's survival and may shorten the time patients spend on the national transplant waitlist, according to two studies published July 28. 

"This research confirms previous data that these hearts — once considered high risk — are safe," said Howard Eisen, MD, chair of the American Heart Association's Heart Failure and Transplantation Committee of the Clinical Cardiology Council. "These findings should encourage institutions who are not routinely using hearts from drug users to do so. It will reduce the waiting time and the number of deaths among people on the heart transplant waitlist." Dr. Eisen was not involved in the two studies. 

The first study, published in Circulation: Heart Failure, involved more than 23,000 heart transplant recipients who underwent the procedure between 2007 and 2017. Researchers compared the recipients' survival rate between those who received a heart from an illicit drug user to those who received a transplant from a donor that did not use drugs. 

Findings showed similar survival rates between both groups. For example, about 90 percent of heart transplant recipients whose donors used opioids as well as those whose donors didn't use drugs survived after one year. After five years, the percentage of surviving recipients for both groups was about 77 percent, reaching 60 percent by 10 years. Researchers also observed similar findings for other types of illicit drugs. 

The second study, published in Journal of of the American Heart Association, considered the number of donor hearts accepted or declined from 1995 to 2018. Researchers then compared survival rates among patients who received a heart from a donor who died of a drug overdose or had hepatitis C, to those who received the organ from donors who didn't die of an overdose or have the viral liver infection. 

Compared to 2003-07, heart organ donors from 2013-17 were more likely to have high blood pressure and diabetes and to have used illicit drugs, which increases the risk for hepatitis C. Still, the death risk among recipients from 2013-17 was 15 percent lower after one month compared to the earlier period. One year after transplant, the risk of death was 21 percent lower for those who received their heart from 2013-17. 

"We hope that patients who are awaiting transplants are encouraged to accept hearts from donors who had hepatitis C or who died due to a drug overdose, if their healthcare team finds the donor heart to be an appropriate match," said Ravi Dhingra, MD, lead author of the second study and medical director of the heart failure and transplant program at the University of Wisconsin-Madison. 

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