Can Snakebite Victims be Potential Organ Donors? A Brief Report

Introduction: Snakebite poses a substantial global health challenge, impacting millions every year. Nearly 5 million individuals worldwide are bitten by snakes annually, resulting in approximately 81,410–137,880 deaths, despite concerted efforts to save lives. Similarly, the growing global prevalence of organ failure due to end-stage diseases underscores the critical need for organ transplantation. Given the sizeable number of fatalities among snakebite victims, there exists a potential opportunity to utilize them as marginal or unconventional donors to fight the organ shortage crisis. Aims: This brief report aims (1) to study the demographic characteristics and patient data of snakebite victims who became deceased organ donors till date. (2) To examine the rationale for the feasibility of salvaging organs in such scenarios and to assess their outcomes. Methods: PubMed, Scopus, Web of Science, and Embase were searched on April 07, 2024, using the string: “(Snakebite OR envenomation OR snake venom) AND (Organ donation OR organ transplantation OR organ graft OR tissue graft OR tissue donation OR tissue transplantation OR donor selection OR organ wastage) AND (Liver transplant OR Lung transplant OR Cornea transplant OR Kidney transplant OR Heart transplant) AND Humans.” Only English-language studies (all types) containing real patient data were considered for review. Results: A total of six studies, i.e., four case reports and two retrospective observational studies were selected for review. Discussion: The first-ever published report (1998) on a renal transplant from a snakebite victim strongly advised against future attempts due to massive hemorrhage and rupture of the transplant. Such fatal complications were attributed to the accumulation of venom fractions in the kidneys and persistent hemotoxicity of viperid bites. Contrastingly, kidney transplants from donors with neurotoxic snakebites exhibited favorable outcomes in terms of graft survival. Similarly, a liver transplant was successfully conducted by retrieving it from a hemotoxic snakebite donor, and corneas were successfully retrieved from snakebite donors and transplanted. Animal studies have also indicated that the snake venom neurotoxin depletes complement levels, thereby suppressing the humoral immune response and potentially enhancing transplant outcomes. The mean age of the donors reported in the studies included here was 35.4 ± 24 years, with a male-to-female ratio of 22:6, and an average success rate of 79.2%. Conclusion: In summary, kidney transplantation from neurotoxic snakebite donors showed a considerably favorable outcome with occasional complications. By the same token, the liver and cornea transplantations from the snakebite donors demonstrated successful outcomes without significant complications in the available literature. There is an urgent need for transplant surgeons and medical toxicologists to set aside any prejudicial attitudes and carefully consider neurotoxic snakebite victims as potential organ donors, particularly for kidneys and corneas. This approach could significantly expand the donor pool, provided that appropriate caution is exercised to ensure the safety and viability of the organs.