Canada's organ donation system is failing patients, and the solutions include having registries in each province and depending less on the United States for tissue, a new report says.
The Canadian Blood Services Call to Action report says implementing its recommendations would result in almost 1,000 more life-saving transplants annually and get patients off costly dialysis.
Although the costs of implementation would be high during the first five years, it would decrease to $47.8-million by Year 10.
Of particular concern is tissue donation - transplants of corneas and heart valves, grafts of bone and skin - said the report, obtained by The Globe and Mail, noting "Canada imports approximately 80 per cent of its tissue product - a dependency that could pose risks to Canadian patients."
Canadian Blood Services spokesman Ron Vezina said on Monday night that he could not discuss the report, which he described as embargoed, but said the agency supports intent-to-donate registries.
Such a registry is being unveiled at a news conference on Tuesday by Ontario Health Minister Deb Matthews at St. Michael's Hospital in Toronto. It will be the second in Canada, after that of British Columbia.
The ease of registering consent to be an organ donor online at beadonor.ca could mean "thousands of Ontarians will take the time to sign up," said a government source, who predicted a "big spike" in people registering their intent to donate their organs and tissues after death. Currently, the public express their wishes to donate organs by mail or in person at a Service Ontario centre, which is seen as inconvenient.
The number of patients requiring organs is climbing. Last year, 4,529 Canadians, including 1,515 in Ontario, were waiting for transplants, according to the Canadian Organ Replacement Register. A total of 2,153 organs were transplanted and 247 people died waiting.
Many on the waiting lists require kidneys - about 3,300 last year - a reality that Steve Dembicky, 54, of Mississauga, Ont., knows all too well. He has been on dialysis for the past four years, which is so tiring that he often has to rest for an afternoon to rebuild his energy.
"The thing I miss is being able to go away," said Mr. Dembicky, who has to restrict his diet and the amount of fluids he can drink. "My entire life is built around my medical treatment."
He has been told the average wait time for a kidney match with his blood type is five to seven years.
The waits are also lengthy for those awaiting tissue transplants, 80 per cent of which are obtained through the United States. The report said this dependency could put Canadian patients at risk if demand exceeds supply.
"Tissue production in Canada is limited by the number of donors, the capacity to recover tissue and the focus on meeting only local needs," the report said. "As a result, end-users across Canada cannot consistently rely on their tissue banks to have the type, quantity and quality of tissue product they need."
Other recommendations include public awareness campaigns and doctors taking a leadership role in hospitals to drive organ and tissue donations.
Vancouver-based corneal transplant surgeon Paul Dubord, vice-chair of SightLife, the largest eye bank in the world, described the demand for organs and tissues in Canada as huge.
"You have patients in Canada waiting for corneal transplantation for up to three and four years. … This is not just Ontario, this can be in other parts of Canada, and in many respects, these waits can be fixed," said Dr. Dubord, who has not seen the report.
Patients waiting for corneal transplants suffer with poor vision, chronic discomfort and poorer quality of life, he said.
"We have to remember," Dr. Dubord said, "that it's all about patients and improving the quality of their lives. That's the bottom line."