The Alliance

Spotlight Series

The Alliance Spotlight Series is a recurring one-page publication for front-line healthcare professionals, offering quick-takes on critical topics affecting the field of organ donation and transplantation. We encourage you to download these issues and share them with your front-line colleagues and partners.

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Opioid.
The U.S. epidemic of opioid addiction and overdose has significantly impacted another major health crisis concerning the pressing need for life-saving organ transplants.

The Opioid Epidemic: Organ Donation and Transplantation

The Impact on Organ Donation

The U.S. epidemic of opioid addiction and overdose has significantly impacted another major health crisis concerning the pressing need for life-saving organ transplants. The collision of the two crises has led to an increase in organ availability due to the generous gift of grieving families who have lost a loved one from a drug-related death. Quite often these deaths pose an increased risk of transplant-related infections.

What Qualifies as Increased Risk?

The phrase “Increased Risk” refers to the characteristics of an organ donor that could place the potential recipient at an increased risk of disease transmission. In 1994, the Centers for Disease Control (CDC) outlined what was known as “High Risk” criteria to address the behavioral risk factors associated with HIV. In 2013, the US Public Health Service (PHS) published new guidelines that would not only address HIV transmission but also the potential transmission of the Hepatitis B virus and Hepatitis C virus through organ transplantation.

There are a variety of exposures that carry different risks of transmitting infections that may cause a potential organ donor to be labeled as “Increased Risk.” To review the PHS Increased Risk Guidelines, visit https://optn.transplant.hrsa.gov/media/1163/2013_phs_guideline.pdf.

Additionally, in 2014, the United Network for Organ Sharing (UNOS) identified three additional criteria that classify a donor as “Increased Risk.”

  • No Donor Risk Assessment Interview (DRAI) conducted (1)
  • Hemodiluted Serology Specimen (2)
  • Hemodialysis in the last 12 months (Increased Risk of Hepatitis C Only)

The Impact on Organ Transplantation

Despite the rapid increase in organ availability, utilization of these organs by transplant programs require additional considerations. These include weighing the risk of disease transmission, the experience and comfort level of transplant surgeons, medical-legal concerns, organ refusal by the potential recipients who have been informed of the increased risk, and the overall stigma associated with PHS increased risk designation.

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To access tools on evaluating suitable recipients for PHS Increased Risk Organs, please visit http://transplantmodels.com/ird.

Helpful Resources

  1. DRAI – An interview conducted with the family to determine additional risks of disease transmission that may not have been previously identified during
    the medical evaluation. In some cases, families are not available or able to address the questions.
  2. Hemodiluted Serology Specimen – All donors undergo blood tests to screen for infectious diseases. If these samples are hemodiluted, it can impact the correct interpretation of the results.

Questions & Comments

Please send all questions and/or feedback to [email protected].

The content of this issue is based on a webinar presentation by Sharyn Sawczak, RN, CPTC, CTBS (Assistant Director of Clinical Services at the New Jersey Sharing Network, New Providence, NJ) and Samantha Aitchison, MD (Transplant Surgeon at Saint Barnabas Medical Center, Livingston, NJ). A special thanks to Sharyn and Dr. Aitchison for their contributions to this in-service.

Worth Sharing
Education Corner Vol IV Issue 9

A Special Thanks to This Series’ Contributors

DD6A2041 JD Edited
About the Editor |
Corey Bryant

Corey Bryant leads The Alliance’s communications, marketing and strategic efforts for unique national events, programming, partnerships and business development. With extensive corporate and non-profit experience, Corey has served in communications and public relations roles for Disney Parks and Resorts, Disney Cruise Line and TransLife (now OurLegacy), the OPO serving East Central Florida. He has also been an active board member of Donate Life Florida, having served as state team leader for Driver License Outreach. Corey is a proud alum of The University of Alabama and serves on the board of directors for Come Out With Pride Orlando as well as Five Horizons Health Services, a not-for-profit organization providing access to progressive HIV testing, prevention and LGBT+ focused healthcare throughout West Alabama and East Mississippi.

Deanna Fenton
About the Editor |
Deanna Fenton

Deanna is a knowledgeable and versatile professional with diverse experiences in healthcare, client relations, marketing, project management and demonstrated skills in leadership and advocacy. Prior to joining The Alliance, she worked in Hospital Development at her local OPO in the state of New Jersey where she served as the clinical liaison to a number of Level 1 Trauma & Neuroscience centers as well as community hospitals. Her personal connection as a donor family and friend fuels her passion to support her colleagues across the donation-transplantation continuum through the development of valuable educational resources that ultimately boost performance and improve outcome measures. Deanna holds a Bachelor of Arts in Psychology and a minor degree in Public Health from Montclair State University. In her spare time, Deanna enjoys visiting vineyards, spending time with her family, and traveling in hopes of visiting all seven wonders of the world.

Advancing All.

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