Should a homeless person become a deceased organ donor?

Area of Science:

• Transplantation immunology
• Public health
• Medical ethics

Background:

• Deceased organ donation is crucial for saving lives.
• US Public Health Service (PHS) high-risk donors are utilized to expand the donor pool.
• The homeless population often presents with unaddressed medical and substance abuse issues.

Purpose of the Study:

• To investigate the suitability of homeless individuals as deceased organ donors.
• To compare the characteristics of homeless and non-homeless prospective organ donors.
• To evaluate the potential impact of homelessness on organ donation outcomes.

Main Methods:

• Retrospective review of 193 brain-dead prospective donors in Hawaii (2013-2018).
• Comparison of homeless (n=13) and non-homeless (n=180) prospective donors.
• Analysis of demographic data, medical history, substance abuse, PHS high-risk status, and organ procurement/transplantation rates.

Main Results:

• Homeless prospective donors were older and had higher rates of substance abuse, including methamphetamine and cocaine use.
• A higher proportion of homeless donors trended towards PHS high-risk designation.
• No significant differences were observed in medical history, hepatitis serologies, donation authorization, or organs procured/transplanted between groups.

Conclusions:

• The homeless population represents a potential source for deceased organ donation.
• Higher prevalence of high-risk behaviors in homeless donors necessitates careful evaluation.
• Larger studies are required to characterize organ donation from this population and monitor disease transmission.