And the list goes on…
When provinces all over Canada improved road infrastructure the intentions were to eliminate fatalities. However, it since became apparent that this good-natured initiative severely reduced the hope of survival for 626 Albertans, according a leading health professional.
Last year, the organ donation waiting list in Alberta officially became the largest in Western Canada for 2008.
With technological advancements over the past decade, more patients are being approved to receive organs, driving up the demand for donors and causing procedures to turn to desperate measures.
”There is a lot of support for it, but the reality is we’ve made a lot of headway in terms of road safety, and that’s where a lot of donated organs came from in the past,” explains Margaret Keresteci, manager of clinical registries for the Canadian Institute for Health Information.
“So it’s kind of one of those double edge things, it’s a wonderful thing that we’ve done so much, that we’ve made so many improvements in road safety but as part of that it means we have to rethink our strategies of donated organs.”
Because Canada is also noticing an aging population the likelihood that organs can be donated at an older age has also become less likely. Currently, the fastest growing population segment is made up of seniors 65 years and older who make up 4.2 million of the over 33 million Canadians. That number is expected to double to nearly nine million, resulting in a quarter of Canada’s population, in the next 25 years. This adds another factor to the growing waiting lists, as more and more people now need organs.
Despite high support, not enough organs are available to meet the needs of growing lists. With 626 patients currently waiting in Alberta, there were only 96 deceased donors in total for 2008. The number of deceased donors in the younger generations aged 18 to 25 province-wide only totaled 13.
“In that younger age group we don’t see as large a proportion of donors, I don’t know what the reason for that is. I’ve heard it suggested that it might be because in that age group people aren’t thinking that they may die at some point so it’s not on their life radar at that point in time,” said Keresteci.
CIHI reasons that part of the problem lies within communication, when in fact becoming a donor is relatively easy. All it requires is a signature on the back of the Alberta Health Care card and informing family members of the decision to donate.
When family members are not aware, the organs are often not donated because consent from next of kin needs to be obtained prior to the organ recovery. Donor cards can also be obtained.
According to Human Organ Procurement and Exchange there are more people dying while on waiting lists. That number has now escalated to be between 15 to 20 per cent before a suitable organ is found.
The Calgary Police Department released its 2008 monthly statistical reports showing that nearly 30 fatal collisions occurred in Calgary throughout the year from January until September, down from 37 the year before. It is unknown how many organ donors were involved.
Therefore, over the past year-and-a-half, organizations have turned to a procedure that has so far only been made available in Toronto and Alberta.
The focus has turned to living donors, which involved 36 participants in Alberta last year. And while only the kidney and liver could be donated in the past, recent advancements have provided Alberta and Toronto with the option of transplanting a portion of a living donor’s lung. One bilateral lung transplant has been recorded in last year’s mid-year report.
“One of the things that became really clear is that there’s been a lot more lung transplants being done in Canada and part of that is that we’ve perfected a checkmate where we can use lobes or parts of lungs of living donors,” Keresteci explained.
“So that’s an example of how people are trying to find new strategies and new ways to improve organ donation, realizing that there aren’t as many deceased donors as there used to be. It’s happening more frequently, but like any new technique, the more that it gets done the more widespread it’ll be.”
Ten years ago the situation was reversed as lists were relatively low for lung transplants and only a few were performed. Now, as the number of lung transplants has increased, so has the list.
When deciding to be a living donor, there are certain procedures that are required to test for health and compatibility. Usually such steps are being taken through the family physician. And even though more transplants are performed and clinicians and organ procurement organizations are looking at different ways to get organs, it’s important to note that every year Canada has roughly more than 3,900 patients still waiting on the list.