Having languished on a transplant waiting list for more than four years with no guarantee he would ever obtain a kidney in Canada, Glen Wood put $40,000 (U.S.) down at an American hospital and waited for the telephone to ring.
Last month, in the middle of the night, he received the call he'd been waiting for — the organ of a dead 49-year-old American was his.
The 75-year-old hastily threw together a bag of clothes, then he and two others made the early dawn drive from his home north of Toronto to the Buffalo-based Erie County Medical Center Corp.
On Jan. 16, surgeons transplanted the kidney into him.
“They're as excited as you are that you are going to get a kidney,” Mr. Wood, a former co-ordinator of music for the North York Board of Education, recalled in an interview from his Richmond Hill home.
By getting the transplant, he was able to end his three-times-a-week dialysis sessions. He also struck himself off an Ontario waiting list that may never have provided him the organ he so desperately needed.
This is because Mr. Wood discovered the best-kept secret in the transplant community: Canadians can obtain organs in the United States quicker than they can here, where queues can last many years and hundreds die waiting.
At a time when Canadians are soliciting organs over the Internet or travelling half a world away to pay live donors for kidneys, Mr. Wood found that the answer was as simple as crossing the U.S. border.
Unlike Canada's organ transplant system, which does not allow foreigners on its waiting lists, the United Network for Organ Sharing, or UNOS, allows U.S. hospitals to perform up to 5 per cent of all types of organ transplants on “non-resident aliens.”
This policy allows moneyed Canadians to hedge their transplant bets. By putting themselves on two waiting lists — one in their home province and another in a U.S. hospital — they improve their odds of receiving an organ.
So long as Canadians can meet the hospital's financial requirements — paying a comparable rate to that of a U.S. citizen or insurer — the place they occupy in the organ queue is no different than that of an American.
No figures are available on how many Canadians have received transplants at U.S. hospitals. However, figures from UNOS, which administers the only organ procurement and transplantation network in the United States, show that 3,365 non-resident aliens obtained organs from Jan. 1, 1988, to Oct. 31, 2005.
Several Canadians have gone to the Miami-based Jackson Memorial Hospital to get transplants, mostly kidneys, its spokeswoman, Lorraine Nelson, confirmed. She refused to provide further details on the associated costs and the length of time these Canadians wait for organs.
In Canada, the scarcity of organs is exacerbated by the lack of a national system. Since most donor kidneys stay within provincial boundaries, highly sensitized patients who are incredibly difficult to match due to antibodies they have against donor tissue, can linger on a list for up to two decades.
Manitoba's solution to this problem has been to send these hard-to-match patients to Minnesota to receive donor kidneys.
“Until we have a Canadian system, there is no other option for individuals in Manitoba,” said Peter Nickerson, a transplant nephrologist at Winnipeg's Health Sciences Centre.
This particular subset of patients, most of whom developed antibodies during pregnancy or childbirth, can linger in the organ queue for 16 to 20 years, he said. That compares against other patients without those sensitivities who wait three to four years in Manitoba.
“Over all, the real solution is for Canada to develop its own strategy,” he said.
Dr. Nickerson stressed that the Minnesota solution is only for those highly sensitized Manitobans requiring kidneys and it would not be used for patients like Mr. Wood, who had no known compatibility problems.
