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Organ and Tissue Donation and Transplantation 
 April 2020 - Newsletter Digest
Now more than ever, we recognize the need to reflect on and acknowledge our collective efforts to improve the organ and tissue donation system for the benefit of all Canadians. This digest provides information on our collaborative work and is the first of a series of news digests to let you know about work underway, some is ongoing behind the scenes,  and some you may be involved in or leading.

We rely on a vast network of experts (advocates, donors, patients, and, of course, professionals like you) who work tirelessly toward improving the organ and tissue donation and transplantation system for patients in need of transplant. Thank you! With your continued support and collaboration, a world-class system in Canada is possible. 

Amber Appleby, Director 
Organ and Tissue Donation and Transplantation 
Canadian Blood Services

Responding to COVID-19 


As the COVID-19 pandemic evolves, administrative and medical leads from across OTDT in Canada are meeting regularly to develop recommendations that can be used by provincial organ donation organizations and regional transplant and donation programs to guide the administration of services. A number of resources are available and projects underway to inform the national response to COVID-19. 

Resources Work underway
  • Weekly meetings for national and international communities
  • Transmission risk analysis related to tissue
  • Development of criteria for resumption of transplant programs
  • Collaborative work with CST and CDTRP on:
    • Collecting data on transplant patients with COVID-19 
    • COVID-19 evidence gathering and synthesis  
Work on pause 
  • All donation and transplant surgeries related to the Kidney Paired Donation program are postponed. Updates will be posted here 
  • Many project and advisory committee meetings have been postponed or cancelled. We continue to work with the Chairs and Co-chairs of OTDT committees to determine appropriate times to reschedule and resume work. 
For more information about resources and projects underway, email: otdt@blood.ca 
 

National clinical trial: COVID-19 convalescent plasma 

Canadian Blood Services is part of a national clinical trial to test the safety and effectiveness of COVID-19 convalescent plasma as a possible treatment to help patients with the virus. 

Learn more

A Tribute to Dr. John Dossetor

Dr. John Beamish Dossetor, a celebrated physician and bioethicist, a pioneer in kidney transplantation and health ethics, and co-founder of The Kidney Foundation of Canada, passed away on Monday, April 6, 2020, at the age of 94.

It has been said that Dr. Dossetor was an incredibly engaging human being who brought a great depth of clinical knowledge, an uncommon degree of common sense, and genuine compassion to decision making, open discussion and debate across clinical medicine, ethics, and life in general. A wonderful person, he left the world a better place than he found it... 

HLA Journal Club

The HLA Journal Club is an initiative led by the National HLA Advisory Committee with the goal to create various platforms to transfer knowledge to the next generation of HLA Lab Directors in Training. 

The virtual HLA Journal Club Webinar series rotates speakers from HLA Labs across Canada. So far, four sessions have been held. In April, "Out of thin air: Determining Positive Cutoffs in Flow Cytometry Crossmatch Assay" had almost 50 participants! There will be more sessions planned as feedback suggests this is a valuable engagement opportunity. 

Multi-language resources for living donation

Living Kidney Donation and Kidney Paired Donation information brochures have been translated into 10 different languages including Cree, Ojibwe and Oji-Cree. 

Recent publications and clinical tools


Management of the neurologically deceased organ donor: A Canadian clinical practice guideline
CMAJ April 06, 2020 192 (14) E361-E369; DOI: https://doi.org/10.1503/cmaj.190631

Building on Canadian recommendations for organ donor management first published in 2006, the 2020 guideline provides updated recommendations for the medical management of neurologically deceased adult and pediatric potential donors with the aim of helping organ donation organizations, policy-makers, administrators, and clinicians who manage neurologically deceased organ donors. 
  • Complementary resources: Links to the article and full guideline document are available on the Canadian Blood Services professional education website. Also available are a number of knowledge translation tools created to facilitate implementation of the guideline. It is our hope that this work can optimize use of the scarce resource that donated organs continue to be.
Maintaining the permanence principle for death during in situ normothermic regional perfusion for donation after circulatory death organ recovery: A United Kingdom and Canadian proposal.
Am J Transplant. 2020 Jan 10. doi: 10.1111/ajt.15775. Online ahead of print.PMID: 31922653
  • As a result of the national DCD Hearts Forum held in October 2018, the United Kingdom and Canada collaborated on a paper that suggests techniques to maintain the absence of blood flow to the brain during normothermic regional perfusion.  An analysis and the meeting report from the October forum have been submitted for publication to the Canadian Medical Association Journal.  

Deceased organ donation in Nova Scotia: Presumed consent and system transformation  Kristina Krmpotic, MD, MSc, FRCPC, Cynthia Isenor, RN, MScN, Stephen Beed, MD, FRCPCFirst Published April 23, 2020 Research Article https://doi.org/10.1177/0840470420919129 

Attitudes of healthcare providers towards cardiac donation after circulatory determination of death: a Canadian nation-wide survey.
Can J Anaesth. 2020 Mar;67(3):301-312. doi: 10.1007/s12630-019-01559-6. Epub 2020 Jan 2.PMID: 31898778 English.
Acceptability of cardiac donation after circulatory determination of death: a survey of the Canadian public.
Can J Anaesth. 2020 Mar;67(3):292-300. doi: 10.1007/s12630-019-01560-z. Epub 2020 Jan 2.PMID: 31898773 English.
Organ Donation after Medical Assistance in Dying - Canada's First Cases.
N Engl J Med. 2020 Feb 6;382(6):576-577. doi: 10.1056/NEJMc1915485.PMID: 32023380 
Survey of Canadian intensivists on physician non-referral and family override of deceased organ donation.
Can J Anaesth. 2020 Mar;67(3):313-323. doi: 10.1007/s12630-019-01538-x. Epub 2019 Nov 25.PMID: 31768789 English.
Clinical Guide to Organ Donation - Sign up at campus.blood.ca

Videos from the 2019 Deceased Donation Symposium at the Critical Care Canada Forum 

 The Critical Care Canada Forum (CCCF) took place in Toronto from November 10–13, 2019.  This marked the fifth annual Deceased Donation Symposium, a two-day symposium on organ donation and transplantation and its application to critical care practice featuring sessions on opt-out legislation, medical assistance in dying, and non-perfused organ donation. Presentations from these sessions were recorded and can be found on Canadian Blood Services’ professional education website. 

Additional online learning opportunities: 
National Organ and Tissue Donation Awareness Week
Last week, we recognized NOTDAW in tribute to donors and donor families and the thousands of patients in need of a transplant, as well as those who have died waiting. Though our collective plans to promote donation this April shifted in the wake of COVID-19, we cannot forget the intent of this powerful message. Please continue to spread the word. A toolkit for year-round promotion of organ and tissue donation can be found online here. 
 
Your feedback is welcome, please send questions and comments to OTDT@blood.ca

Our mailing address is:
Canadian Blood Services
1800 Alta Vista Dr
Ottawa, On K1G 4J5
Canada

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