Heroin OD + Transplants

[painmd87]

I've been shadowing an ED physician for the past few weeks and today a patient was dropped off overdosing on heroin.

He was in cardiac arrest and was resuscitated but was brain dead + seizing.

The doctor said he would make a great organ donor -- that heroin is a "clean drug."

So, what all can be harvested from a heroin overdose in an otherwise healthy 30yo? (Heart, lungs, liver, kidneys, skin, retinas, ??)

Are there any clinical concerns about the long term success of these organs post-transplant?

Thanks!

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[roja]

Can anyone move this to the surgery forum? I am sure the transplant surgeons could answer this.....

 

[mikecwru]

Can anyone move this to the surgery forum? I am sure the transplant surgeons could answer this.....

I don't know if we need a transplant surgeon. I see a lot of IVDUers with HIV/HepC. I don't know what they mean by "clean," but I don't know if I'd want a kidney from a known active IVDU.

mike

 

[painmd87]

I don't know if we need a transplant surgeon. I see a lot of IVDUers with HIV/HepC. I don't know what they mean by "clean," but I don't know if I'd want a kidney from a known active IVDU.

mike

Not sure if this makes a huge difference on that opinion -- he had snorted the heroin, one-time use, not habitual.

 

[EBKame]

Heroin is lipophilic, has mostly CNS effects, half life of 30 minutes, and is eliminated via the urine... It isn't metabolized to a toxic compound... this is probably what makes heroin users safe as donors...also, I wouldn't assume that he is an IV drug user... snorting heroin is common precisely because the stigma that is attached to being an IV drug user

 

[WilcoWorld]

Possibly "clean" refers to an absence of direct organ damage caused by the drug. While many other drugs have direct and indirect cytotoxic effects, aside from leading to hypoxia via decreased respiratory drive, as far as I know heroine has no cytotoxic effects. Of course you would want to test the donor for communicable diseases, but I think that's going to be done in any case of organ donation.

 

[EM2BE]

Not sure if this makes a huge difference on that opinion -- he had snorted the heroin, one-time use, not habitual.

I've heard this one before...even on the detox unit. Wouldn't believe it.

 

[Pilot Doc]

Heroin is a narcotic - quite similar to the Fentanyl that any transplant recipient will be marinated in. But as mentioned above, the totally harmless narcotic often keeps some bad company.

 

[ESU_MD]

I've been shadowing an ED physician for the past few weeks and today a patient was dropped off overdosing on heroin.

He was in cardiac arrest and was resuscitated but was brain dead + seizing.

The doctor said he would make a great organ donor -- that heroin is a "clean drug."

Just when I thought I heard all of the reasons to get a patient out of the ER and onto a surgical service!!!!

 

[Bruingirl6]

Just when I thought I heard all of the reasons to get a patient out of the ER and onto a surgical service!!!!

Hilarious!!