Replacing our usual monthly digest for January, in this edition we reflect on 2021 and highlight just a few of the many collective achievements for OTDT over the past year.
Again in 2021, the Canadian Blood Services OTDT team, like the rest of the world, encountered challenge as well as change. Our team continued to rally with you as COVID-19 altered our course. Newcomers adapted to their roles in the midst of great uncertainty. This year we welcomed a new Director, Catherine Butler. Based in Ottawa, Ont., Catherine joins us with extensive experience in health-care and community services within multiple jurisdictions across Canada, and in executive leadership roles in both the public and private sectors. We also bid a fond farewell to David Hartell, who departed the role of Associate Director, System Development to pursue a new opportunity at the end of 2021.
Living donation
Living kidney donor resource centre
A new addition to our website in 2021 is a comprehensive resource centre for living kidney donation. This space offers lots of great information including My Transplant Coach Canada, an online video-based decision aid for patients with kidney failure. It uses animated videos to help Canadian patients understand what treatment options are available, so they can make informed decisions that are right for them. Donors and transplant candidates can find answers to many questions and learn from lived experience, while also finding contact information for their local donor program or transplant centre. In 2022, the resources will continue to grow with the addition of My Paired Donation Coach and an eligibility questionnaire.
The International Living Donation Storytelling Project, a one-of-a-kind digital library of video stories, recorded by real people, sharing their living donor kidney transplant experiences. The digital storytelling platform has already collected hundreds of stories from living donors, recipients, allies, including those exploring the idea of donation, and some looking for a living donor. Storytellers come from diverse backgrounds, geographic regions, age, and life experience. By sharing their candid personal stories, they each help to raise awareness about the need for living donors to help improve the outlook for those waiting for transplant.
Collaboration with Air Canada to ship kidneys takes flight during COVID-19
While Air Canada has certainly been flying fewer people on life-changing trips since the start of the COVID-19 pandemic, the national air carrier has been integral this past two years in helping Canadian Blood Services to transport lifesaving donated organs across the country.
On April 30, 2021, the special presentation When Kidneys Fly highlighted both the Canadian and American experience shipping living donor kidneys by air for kidney paired exchange transplants. The Canadian experience was presented by Dr. Steven Paraskevas, MD, PhD, McGill University Health Centre. U.S. experience presented by Dr. Dorry Segev, MD, PhD, Johns Hopkins University School of Medicine. Watch the presentation here
Number of Kidney Paired Donation transplants reaches annual record high
The kidney paired donation (KPD) team is pleased to announce that the program exceeded 100 kidney paired donation transplants for the year 2021, making it the highest annual number of transplants (previous annual high was 88 in 2019) in a single year.
KPD total transplants to date: 872
KPD transplants for 2021: 105
KPD total shipped Kidneys to date: 102 (32 intraprovincial, 70 interprovincial)
KPD shipped kidneys for 2021: 60
Congratulations to the many cooperating programs and transplant teams that made this stellar year possible and improved the lives of so many.
Working together to improve the system
Though another year has passed without face-to-face collaboration, yet we continued to work together toward many system improvements. A number of successful national forums took place and work continued on operational program developments, all while meeting regularly as a national community to address ongoing impacts of COVID-19. Thank you for your ongoing support and contribution to this impactful work.
700 kidney transplants made possible through HSP program
In only seven short years, the Highly Sensitized Patient (HSP) program has reached a new milestone: 700 transplants! Operated by Canadian Blood Services in collaboration with provincial and territorial governments and organ donation and transplantation programs around the country, the HSP program makes it more likely that people who need a kidney transplant, and are hard to match, will find one. Through the Canadian Transplant Registry platform, this program uses sophisticated technology to match the right kidney to the right patient anywhere in Canada. Learn more
System progress data dashboard (2020)
After collecting a full year of data we shared the annual results for the previous year with the 2020 System Progress Data Dashboard. The results reflected within this data represent the individual and collective work of both the provincial programs and the national efforts led by Canadian Blood Services. Most importantly, we sincerely acknowledge the generosity of the 1,221 organ donors and their families who gave so selflessly in 2020. We also recognize the heartfelt appreciation of the recipients whose lives were saved or changed through the generous act of donation.
Canadian eye and tissue system performance data (2020)
Canadian Blood Services maintains and collates data for review by the Eye and Tissue Data Committee (ETDC). The purpose of this report is to provide information and insights into the Canadian recovery, processing and distribution of ocular and tissue allografts across Canada. We are grateful for all the ongoing efforts of the members of the ETDC and the Data and Publication Working Group, as well as the data representatives at each of the participating programs in Canada who are integral to this work.
Report highlights
In 2020, Canadian eye and tissue banks received 56,335 deceased donor referrals for potential tissue donation, which represents a 3% decrease relative to 2019
In 2020, tissue was recovered from 3,576 deceased donors, representing a 25% decrease from the previous year. Tissue was recovered from 115 living donors, an equal amount as in 2019.
Results relating to ocular tissues in 2020 saw greatly reduced numbers compared to 2019
Canadian Transplant Registry: version 5.0 successfully released
On July 22, CTR version 5.0 was successfully released. This upgrade sets the stage for interprovincial sharing of hearts for high-status recipients. When the functionality is ready for use by provincial partners later this year, the CTR will be able to match available hearts to the most medically urgent and difficult to match heart waitlist patients. We are grateful to the many people and partners involved over the past two years who've made this important step possible. Canadians will soon begin to realize the life-saving benefits of having a nationally consistent, transparent, and accountable heart allocation process. Thank you!
Advancing public education
Organs & Tissues for Life Education Portal launched
We are on a mission to get teachers, students and families talking about organ donation.
Knowledge is key to addressing young people’s concerns about organ and tissue donation. It can help them feel empowered to talk about donation with their families and equip them to make informed choices in the future.
Teach it. Learn it. Talk about it. It's vitally important...
Discover the impact of organ and tissue donation through easily accessible age-appropriate learning resources for educators, parents and students (K-12), including teacher and parent resources for grades K-5 from the Orgamites.
The portal and resources are available in English and French.
To support outreach to educators and advocates we've created a number of tools and promotional materials that you can use. Get in touch to access these materials, customize for your audience and/or add your logo... Contact us at OTDT@blood.ca
The Orgamites arrived in Canada
The Orgamitesare a team of nine life-saving organs (led by Captain Marrow) found in every one of us. They’re known as the "mighty organs" because they represent the most-donated parts of the body. The Orgamites education program inspires children to live healthier, show more compassion for others, and be more environmentally aware.
Every toolkit created has been designed in such a way as to empower teachers, parents and students with informative and exciting resources to learn, teach and talk about this important topic. Join in the conversation @OrgamitesinCanada @MightyOrgamites #MightyOrgamites #OrgansTissuesForLife
Over the past five years, we've been working with a team of subject matter experts from across the country to bring the vision for a national curriculum for organ donation to reality. A required part of training for critical care residents, this curriculum is a key component of our national work to help shift culture to one where organ donation is a normal part of quality end of life care. We were able to enhance this curriculum and respond to emerging needs by adding a submodule about organ donation following MAiD. We are targeting an early 2022 communication and marketing campaign once we have obtained accreditation for the remaining modules.
The Canadian Clinical Guide to Organ Donation is an eLearning-based curricula for health-care professionals who care for and support donors and potential donors. It includes evidence-based peer-reviewed material and is accredited for critical care residents to meet their certification requirements for organ donation.
Experts were recruited to author specific parts of the curricula (i.e. chapters and case scenarios), which were peer-reviewed and professionally edited. Once the content was developed and assessed, a software development team built a custom eLearning tool to meet the specific needs of the knowledge.
Identification and Referral* (2 hrs section 3 MOC)
Neurological Determination of Death* (4.5 hrs section 3 MOC)
Donation after Circulatory Death (3.5 hrs section 3 MOC)
Management of a Neurological Donor
Communication
Submodule on MAID and Organ Donation
Professional education got a brand new look!
We're excited to share our redesigned Professional Education website. Although the look is new, the content remains the same. We hope the new design will make it easier to find and use the content you’re looking for.
The BRiC Study
Burnout, compassion fatigue and work-related stressors among organ donation and transplantation coordinators: A qualitative study
Organ and Tissue Donation Coordinators (OTDCs) are health-care professionals who manage deceased organ donation cases. This study investigated the experiences and perceptions of OTDCs, pertaining to compassion fatigue, burnout, and resilience as it relates to their daily work.
Death Prediction and Physiology after Removal of Therapy (DePPaRT) Study published in NEJM
The Death Prediction and Physiology after Removal of Therapy (DePPaRT) Study, led by Dr. Sonny Dhanani, was published in the January 28 issue of the New England Journal of Medicine.
Monitoring more than 600 patients’ vital signs during the dying process, this is the largest international study of its kind.
This important work will inform the national death determination clinical practice guideline currently being updated by Canadian Blood Services, the Canadian Critical Care Society, and the Canadian Medical Association, in partnership with the Health Canada Organ Donation and Transplantation Collaborative. The DePPaRT study will also form the foundation for other important research projects, including the Health Canada Donation Advisor study and the NeuroPART study.
Congratulations to the entire DePPaRT team on this impactful and seminal work recognized in this important publication.
A 13-year-old Ontario girl is looking forward to a bright future after a lifesaving transplant made possible by transplant and her very selfless former babysitter. Read the full story
A very special bond
Sxeláltenaat was already a mother of two when she met Alissa. Both were post-secondary students, but Alissa was much younger — only 17 — and had been living on her own. Sxeláltenaat offered to adopt her. And when a medical exam revealed Alissa’s kidneys were failing, she also became her kidney donor... Watch Sxeláltenaat's story on Facebook
Taking education about organ and tissue donation to new heights
The Chain of Life program is currently being taught in approximately 100 schools in Quebec. Already, nearly 100,000 young people have been touched by its message, and Canadian Blood Services hopes to help it reach even more. The Chain of Life curriculum is one of the resources included in the new Organs & Tissues for Life Education Portal, which was developed in collaboration with the broader community of organ and tissue donation and transplant organizations in Canada. Read more
BC’s health-care teams work together to make organ donation possible amidst one of the province’s worst wildfire seasons
Due to wildfires and smoke, flights were cancelled and airports shut down. BC Transplant's organ donation specialists and in-hospital coordinators had to try everything possible to fulfill the wishes of the organ donors and their families, and for those patients waiting for a second chance at life.
Humboldt Bronco father asks Saskatchewan to unite again and get vaccinated
Toby Boulet, the father of former Humboldt Broncos player Logan Boulet, is asking Saskatchewan residents to come together, like how they did after the 2018 crash, and get vaccinated.
UBC discovers innovative coating for blood vessels reduces rejection of transplanted organs
Researchers at UBC have found a way to reduce organ rejection following a transplant by using a special polymer to coat blood vessels on the organ to be transplanted. The discovery has the potential to eliminate the need for drugs, typically with serious side effects, on which transplant recipients rely to prevent their immune systems from attacking a new organ as a foreign object. The findings were published in Nature Biomedical Engineering. Read more about the study here.
Lethbridge coach posthumously honoured with Logan Boulet Award
Ric Suggitt received the 2021 Logan Boulet Award. Recognized nationally for inspiring Logan Boulet, one of the victims of the Humboldt Broncos crash, who in turn became an organ donor and inspired a movement. Read the full story
Saskatchewan halts organ donation program due to COVID-19 surge
Saskatchewan has paused its organ donation program as a result of surging COVID-19 cases in the province. The pause to the program applies to all but a few limited procedures and will last indefinitely. CBC News article
Nurse goes the extra mile to save a life – by donating one of her own kidneys
Kirby Pickard came across a kidney donor outreach pamphlet while on shift one day at VGH back in 2015. The quick second glance that caught her eye, ended up saving the life of Monika Colmorgen.
Fewer than 3% of Nova Scotians have opted out of being organ donors
Dr. Stephen Beed, medical director of Nova Scotia's organ and tissue donation program Legacy of Life, reports on the deemed consent program progress since its launch in January.
Flow is not perfusion, and perfusion is not function: ancillary testing for the diagnosis of brain death
Published in the Canadian Journal of Anesthesia, this paper provides a short critical appraisal of ancillary testing for neurologic death while providing a deeper conceptual and physiologic understanding of the distinctions between brain flow, perfusion, and function. Also proposing actualized definitions of flow, perfusion, and function based on a neat conceptual model. Read article
Laura's gift
When Laura Stairs died in Mexico, two countries away from home, family members did what they knew the woman known for her hugs would want: made sure her organs got to others. Pam Gaines, who got a new heart, needed to meet this family.
Three ways to learn more about the power of living organ donation
These online resources are for potential donors, transplant candidates, and anyone with an interest in organ and tissue donation. Read article
Building resiliency in health care
Organ coordinators endure high rates of burnout. Canadian Blood Services and the Children's Hospital of Eastern Ontario aim to change that. Learn more
Continuing to adapt to COVID-19
A special shout out to Drs. Graeme Dowling, Sam Shemie and Michel Pâquet who stepped forward early on and have continued to lead the monthly eye and tissue, international, and national COVID response calls since March 2020. Thank you for your leadership and service!
Preliminary Results Data Dashboard
Originally developed as a COVID-19 impact data dashboard in 2020, the preliminary results data dashboard shares recently collected, unvalidated data to help the community better understand, in near real-time, how the system is performing.
Administrative and medical leads from across OTDT in Canada continued to meet regularly to share recommendations, evidence and information as it became available to help guide the administration of services by provincial organ donation organizations, eye and tissue programs and regional transplant and donation centres in this unprecedented time.
International cooperation
When the pandemic began, Canadian Blood Services invited international donation and transplantation experts to meet on a regular basis to discuss and share experiences and information about COVID-19 and the impact systems around the world were facing. Hearing from countries like Spain, the U.K. and Italy who were further ahead in the pandemic timeline informed our response approach.
PREVenT COVID: Vaccination in Transplant Patients
UHN researchers receive $2.84M to study COVID vaccine efficacy and safety in transplant patients. Dr. Deepali Kumar at UHN is leading a Canada-wide research initiative to determine the effectiveness and safety of COVID vaccines in transplant recipients. Read more about this work
Recently published in the BMC Medical Ethics journal, a literature review summarizes the ethical issues as part of the COVID-19 Rapid Response Recommendations project. The aim of the publication is to inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies of international concern.
Another year to leave behind
A message from Catherine Butler, Director, Organ and Tissue Donation and Transplantation, Canadian Blood Services
I joined Canadian Blood Services’ Organ and Tissue Donation team as Director last April, and I’d like to share with you my sincere thanks for welcoming me into this wonderful and committed community.
I recognize for many, 2021 was a genuinely tough year. Moments of in-person connection which were so needed this past year were again delayed as the world continued to navigate this new pandemic reality. Our system partners were (and still are) deeply challenged to continue operating in a health system under growing pressure due to COVID-19. Yet, you still remained as passionate as ever about our common goals. To say this is commendable would be an understatement.
We thank all system collaborators and partners, our colleagues at provincial ODOs, donor and transplant centres, representatives from ministries of health and health authorities, patients, donors and donor families, for their ongoing support and engagement as we work together to continue to improve the national OTDT system on behalf of all Canadians. We are grateful to Health Canada and the provincial and territorial governments who fund this important work.
As we open the door to 2022, I look forward to our continued, and deepened collaboration to improve the OTDT system in Canada for patients and their loved ones. I don’t know what 2022 will bring, but I am hopeful. I am also both confident and glad that whatever comes – we will face it together.
Canadian Blood Services sincerely acknowledges the generosity of the organ and tissue donors, and their families and loved ones, who gave so selflessly to provide hope to transplant candidates across the country.
Your feedback is welcome, please send questions and comments to OTDT@blood.ca
