Canada has one of the lowest organ-donation rates among developed nations. Every day and a half, a patient on a wait list for a kidney, liver, heart or other organ dies.
Many of these deaths are preventable. Surveys routinely show that Canadians are willing to donate their organs and tissues. Canadian Blood Services' new report has many useful recommendations to reform the system - and save lives and money in the long term by increasing the pool of donors.
A national online registry is a welcome first step. Instead of requiring Canadians to mail in a consent form, they could do so online (already, British Columbia has an online intent-to-donate registry, and this week Ontario launched its own version, beadonor.ca). This could expand the potential network of donors, facilitate more transparency around wait lists and standardize organ-allocation criteria.
The capacity to recover donated tissue, which is used in everything from knee replacements and dental work to heart valves, in Canada is so poor that 80 per cent of the supply is imported from the U.S. This too is unacceptable. Dependence on the U.S. poses a risk to patients, when demand exceeds supply, and it raises questions about quality management.
Canada also needs a uniform approach to donation in critical-care settings. Even when families initiate a conversation around this issue, hospitals cannot always offer the expertise, resources and access to operating rooms to follow through on an organ or tissue donation. The government should train medical professionals whose sole role would be to liaise with families and make sure this process becomes a regular part of end-of-life care.
While these reforms will require extra funding, they will be financially advantageous in the long term. By the 10th year, the report estimates the investment would decrease from a high of $130-million a year to $47-million a year, and 1,000 additional transplants could be done. An increase in the number of transplants also saves millions of dollars in dialysis treatments.
There are already many pockets of excellence within the system, for example the newly launched living donor paired exchange, which pairs donors whose blood and tissue type turns out not to match their intended recipient with another patient in a similar position. It has facilitated transplants for 69 patients. But progress is uneven, with patients in some provinces still facing five-year wait lists for kidneys.
Many Canadians are prepared to donate their organs and tissues; it is time to make it easier for them to do so.
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