Organ Donation & Transplantation in Canada: Rising to the Challenge
News Organ donation and transplantation are uniquely complex medical acts. Each organ donation and the transplants that result can involve literally hundreds of health care professionals, working together to give up to six people a life-saving organ, and many others access to vital tissues.
In no other field does a surgeon in Halifax need to work closely with a medical specialist in Edmonton, and a lab in Toronto to make minute by minute decisions. While this type of team work makes transplantation so remarkable, it also presents a significant challenge. Canada’s transplant community does not lack for expertise, dedication and excellence. But in some measures of system performance, such as organ donation rates, Canada has lagged behind many other developed nations, in spite of our overwhelming public support for the concept of organ donation. Improving Canada’s donation and transplantation system is not an easy task, but perhaps focusing on these key areas could make a difference:
"Without local donation specialists, there is variability in adherence to best practices, and in engagement by front-line professionals who, in general, are under-resourced by our system to enter into this complex decision with their patients’ families."
Specialized leadership in organ donation
The experience of Spain, a global leader in organ donation, as well as the UK and some parts of the US has highlighted the importance of donation physician and nurse specialists. These clinical roles are not common in Canadian hospitals, yet jurisdictions that have established them have seen remarkable increases in organ donation. Tasked by their institutions to serve both as primary consultants on organ donation, and to develop improvements in system performance, these key individuals ensure that every opportunity for organ donation is realized, not lost to lack of information or communication. Without local donation specialists, there is variability in adherence to best practices, and in engagement by front-line professionals who, in general, are under-resourced by our system to enter into this complex decision with their patients’ families.
Continued public education
While public opinion has been generally favourable, the great variety of cultural backgrounds that make up Canadian society can pose challenges when dealing with questions of organ donation after death. Public education in these areas will never be complete, but by reaching into the community with the help of religious and cultural leaders, taking these concepts to schools and universities, and making use of conventional and social media, it is possible for commonalities to be drawn out of Canada’s complex cultural mosaic. No matter what our belief system, our lives may be touched by the need for a donated organ in ourselves or someone we know. Understanding the options, including the great capacity for good in living donation, is something that can be of benefit to all. Jay Breckenridge and Dr. Aubrey Goldstein highlight the importance of public awareness on page three.
Knowledge creation and translation
Pushing the envelope of knowledge is a tradition of which Canadians should be rightfully proud. The changing nature of scientific discovery, and the concurrent decline in public funding of science has created a difficult environment for Canadian researchers. Developing collaborative efforts across the country, and utilizing common resources in the effort to improve the quality and safety of organ and cell transplantation is the goal of the Canadian National Transplant Research Program. The CNTRP is scientific collaboration writ large, a unified research directive which (as outlined by Dr. Lori West on page seven) is already helping develop novel approaches to everything from organ preservation, to diagnostics and therapeutic approaches to avoid loss of the transplant.
Organ donation and transplantation represent the triumph of human generosity over tragedy, and also the combined efforts of the medical profession and industry in performing this incredible act. These are a few examples of where our greatest efforts are needed if Canada is to become a global leader in this field. Petitioning our elected officials to make this a priority is our common task. Only if adequately resourced, can entities such as Canadian Blood Services and the CNTRP bring about the organizational change and scientific advancement that are needed. It is a great privilege to serve as the President of the Canadian Society of Transplantation, and represent a sector of health care professionals who so exemplify the ideals of team work and collaboration. With your help, we can do even better.