People who died from drug overdoses account for more than one-third of deceased organ donors in British Columbia, which set a record for donations and transplants last year.
According to data released Monday by BC Transplant, the Provincial Health Services Authority and the Ministry of Health, 160 deceased donors and 77 living donors resulted in 563 people receiving organ transplants in 2023.
That is one more deceased donor than the previous year, and surpasses the previous record for transplants in 2021, when 529 people received new organs.
BC Transplant, the agency that oversees all aspects of organ donation and transplant in the province, attributes much of the increase to better communication within the health care system. This includes a years-long effort to educate health care professionals and donation physicians, and build up a network of in-hospital transplant co-ordinators. Hospital referrals of potential deceased donors reached 989 in 2023, up 13 per cent from the previous year.
But the agency also acknowledges the grim reality that a runaway toxic drug crisis has resulted in more deceased donors. Of last year’s 160 deceased donors, 60 died from illicit drug toxicity. That is up from 2017, the year the agency began collecting data on the presence of fentanyl in deceased donors, when 19 per cent died from overdoses.
Sean Keenan, provincial medical director of donation services at BC Transplant, noted the proportion of these donors mirrors illicit drug deaths in the province. In 2019, for example, when B.C. saw a brief decrease in illicit drug deaths, the proportion of donors who had died from drugs was 22 per cent. As drug deaths surged again, they made up 36 per cent of deceased donors in 2020, 32 per cent in 2021 and then about 38 per cent in 2022 and 2023.
“It’s a horrible situation,” Dr. Keenan said of the toxic drug crisis in an interview on Monday. “We would all, in B.C. and in Canada, like this problem to be sorted out. We would probably see a drop in the organ donors, [but] we’d certainly like to see this go back to the pre-epidemic range than what we’re seeing right now, when we were seeing accidental overdoses more in the range of 10 to 15 per cent.”
The figures are similar elsewhere. In Alberta, people who died from illicit drug toxicity accounted for 35 per cent of deceased donors – 34 of 91 – in 2022, The Globe reported last year. That was similar to 2020 and 2021, when people who died of drug overdoses accounted for 33 per cent of deceased donors, and up from 2019, when they made up 13 per cent of deceased donors.
Tommy Picco, of Pitt Meadows, who died from an illicit drug overdose in 2020, at age 36, donated four organs – his liver, his kidneys and heart.Courtesy of family
Tommy Picco, of Pitt Meadows, B.C., was an energetic and outgoing boxer and electrical apprentice who had grappled with substance use for about 15 years. He had tried detox and treatment a few times but self-medicated in part because of chronic pain and was using illicit fentanyl when he fatally overdosed in 2020, at the age of 36.
In hospital, his mother, Debbie Picco, was informed that he was registered as an organ donor. Upon his death, he donated his liver, his kidneys and his heart. The Picco family would later meet the recipient of his heart, a woman about his age, who was also covered in tattoos and outgoing just like him.
“I opened the door and I just didn’t know what to say,” an emotional Ms. Picco said, recalling their dinner. “I don’t know if I was overwhelmed or what, but it was cool. It was very deep.”
Organs from people who have died of drug overdoses are generally no more risky than organs from people who died of other causes and, in fact, are often in good shape given that most people who die from an overdose tend to be young and healthy, Dr. Keenan said. Every potential organ donor receives a full screening and their history is reviewed for risk factors.
B.C.’s deceased donors per million rate is 28.8, making it the leader in Canada, according to BC Transplant. Still, 512 people were waiting for an organ as of Dec. 31, 2023. Dr. Keenan encouraged anyone considering organ donation to register their intent – a process that takes less than two minutes.
Ms. Picco said the donations have been transformational for her family in processing the loss of her son.
“Transplants can make a difference in how you feel after the death,” she said. “It’s something very positive. And I think Tommy would be incredibly proud to have done that. And I think families would be proud of what they have given up.”
Andrea Woo