Replacing our usual monthly digest for January, in this edition we reflect on 2022 and highlight just a few of the many collective achievements for OTDT over the past year.
This digest is an opportunity to reflect on and acknowledge our collective efforts to improve the OTDT system for the benefit of all Canadians. Please share with your colleagues and invite them to subscribe. You may unsubscribe at anytime. Send contributions, comments and suggestions to otdt@blood.ca
Looking back on 2022
Celebrating milestones for interprovincial organ sharing programs
Highly Sensitized Patient program reaches 800 transplants
The Highly Sensitized Patient program hit an exciting milestone in 2022: 800 transplants for the hardest to match patients! These are transplants that otherwise would not have happened.
The HSP program is a national organ sharing program operated by Canadian Blood Services in collaboration with all provincial donation and transplant programs. The program gives provincial transplant programs access to a larger national pool of kidney donors for highly sensitized patients who need a more specific donor match.
National Organ Waitlist celebrates 10th anniversary
Launched in June 2012, the National Organ Waitlist (NOW) provides 24/7 web-based access for non-renal organ transplant programs across the country to list patients in need of a heart, lungs, liver, pancreas, small bowel, or multi-organ transplant. When organs become available, Organ Donation Organizations access NOW via the Canadian Transplant Registry. The NOW is a first step in the organ allocation process to identify patients in most critical need of an organ anywhere in Canada. The CTR sends alerts to provide up-to-date information about organ availability and patient priority.
Working together to improve the system
Shipping kidneys: a donor-centric approach to living donation
Shipping kidneys, rather than requiring living donors to travel to another transplant program, became the norm in 2022 for the Kidney Paired Donation program.
This improvement is the result of years of hard work by the living donation community, and was aided by an initiative led through the Organ Donation and Transplantation Collaborative Living Donation Working Group. Last year, the group worked with Canadian Blood Services' KPD program to develop a medical checklist and a standard operating procedure (SOP) for cross-country shipping of kidneys and made them available as a resource for all living donation programs.
In 2022, 52 kidneys were shipped!
Shipping a kidney instead of asking a donor to travel is now the most common way to deliver a kidney to a recipient when they are not located at the same centre. This means many more donors do not have to leave their family and support system to donate their kidney to a transplant candidate.
New data dashboards improve access to OTDT data
The Professional Education website was updated with many exciting new resources in 2022, including a new Kidney Paired Donation (KPD) program data dashboard. The dashboard provides information on the number of registered participants in the KPD program, matches created each match cycle and kidney transplants facilitated by the program. Data is also provided about kidneys that are shipped between centres for transplant.
My Paired Donation Coach Canada (available in French and English) is a series of animated video modules developed for patients, their friends and family and potential donors to learn about the national Kidney Paired Donation program and how it may help patients receive a kidney transplant.
The learning resource section for living donation on blood.ca is a wonderful way to get acquainted with living kidney donation. There you will find the comprehensive living kidney donor advocacy toolkit, which helps Canadians become an advocate for living donation with tools and resources to help spread the word.
"Participants’ feelings of abandonment and poor-to-little support after their family member’s organ donation provides empirical evidence needed to catalyze structured changes in the way hospitals and organ donation organizations provide support to families of organ donors. Many family members indicated that they wanted to play a role in supporting future donor families."
-Dr. Aimee Sarti
New modules: Canadian Clinical Guide to Organ Donation
The Canadian Clinical Guide to Organ Donation 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. The curriculum was enhanced in 2022 by the addition of two new modules (Neurological Determination of Death and Communication) as well as a submodule about organ donation following medical assistance in dying (MAiD). It's a required part of training for critical care residents, and free to anyone working in organ donation and transplantation.
Discover more on all five modules of the Canadian Clinical Guide to Organ Donation and enroll today at campus.blood.ca
Burnout and Resilience in Donor Coordinators: Study progress update
In the national Burnout and Resilience in Organ Donation Coordinators (BRiC) study, an innovative way to investigate and improve the work-related wellbeing of Canadian organ and tissue donation coordinators through early identification and intervention of work-related issues (e.g., burnout and compassion fatigue) was developed. The goal is to support the well-being and the retention of skilled, trained coordinators, and optimize organ donation among organ donation organizations.
The guidance covers referral of track one patients (who receive MAiD after loss of capacity) and track two patients (who provide informed consent once MAiD eligibility has been confirmed), consent and reporting. It will continue to evolve as new or emerging ethical or practical concerns arise. Publication is forthcoming.
Successful virtual Liver Leading Practice Forum
Many thanks to the clinical and administrative leads, patient partners and team members who contributed to the success of the Liver Leading Practice on Listing Eligibility for Patients with Alcohol Use Disorder forum. The event was held virtually on June 14 and 16, 2022, with additional pre-webinars in the two weeks leading up to that. This Forum is hosted by Canadian Blood Services in collaboration with the Canadian Liver Transplant Network. Guidelines are being developed by consensus among members of the transplant community, including patient partners, and will be based on a rigorous scientific, ethical, and legal review.
A roadmap to guide our reconciliation journey with Indigenous peoples and communities
In September, Canadian Blood Services released its Reconciliation Action Plan (RAP). The RAP is a roadmap for how Canadian Blood Services intends to collaborate and work with Indigenous employees, donors, registrants, partners, stakeholders and communities moving forward. It provides a framework for translating our reconciliation commitments into meaningful actions that will benefit First Nations, Métis and Inuit peoples and communities.
“We are dedicated to evolving Canadian Blood Services into an inclusive place where First Nations, Métis and Inuit employees can thrive, and where rare blood, stem cell and other specific needs of Indigenous patients can be more readily met,” said Dr. Graham Sher, CEO. “Reconciliation requires time, allocation of resources and ongoing commitment — and we are devoted to this pathway of humility, awareness, dialogue and action.”
Honouring Canada's Lifeline: Canadian Transplant Association received the 2022 Logan Boulet Award
Canadian Blood Services was honoured to present the 2022 Logan Boulet Award to the Canadian Transplant Association for its significant contribution to supporting families and to raising awareness about the powerful impact of organ donation. The 2022 awards were distributed as part of the December Open Board Meeting.
The Mighty Orgamites join social media and help raise awareness in 2022
In 2022, the Orgamites made their debut on Instagram and Facebook. They also donned their jerseys in support of Green Shirt Day 2022. The Orgamites made their way into classrooms across the country helping teachers and students learn more about their mighty organs, staying mighty healthy and of course how to be mighty kind.
Keep up with the Orgamites as they continue to remind us all that "It's what's inside that counts"! Visit Orgamites.ca.
Want to bring the Orgamites to your centre? Contact us at OTDT@blood.ca
Animated video explains how organ donation works
Organ donation is an incredible gift. A number of things have to happen in sequence and in a really specific way for a person to become an organ donor. Released just in time for NOTDAW 2022, this animated video produced by BC Transplant and adapted for national use by Canadian Blood Services outlines how organ donation works.
New postage stamp highlights organ and tissue donation
A special stamp designed to raise awareness of organ and tissue donation was unveiled by Canada Post in 2022. The stamp illustration was created by artist Christopher DeLorenzo. The stamp was released as part of Canada Post’s annual stamp program. We're very grateful to Canada Post for honouring organ and tissue donors and their families in this way and for bringing much needed attention to this important topic
Living Donation Week 2022 was a great success, with celebrations, landmarks across the country lit up green, educational opportunities and lots of positive talk on social media - and it didn't end in September! With UHN and YE Group leading the charge, Great Actions Leave a Markis a year-round, multi-year national living donation awareness campaign highlighting stories from donors and recipients across the country.
“Storytelling is part of our tradition as Anishinaabe people,” says Mary. “Sharing the things I’ve gone through helps build relationships, whether it’s with other patients, researchers or policymakers.”
Three-time double lung recipient was a powerful advocate for organ donation
Myles Lynch devoted much of his life to sharing a message about the importance of organ donation. He was driven by both his own experience as a patient and the tremendous need for more organ and tissue donors in Canada.
Myles inspired his sister Jillian to carry on his efforts. Their story was celebrated during National Organ and Tissue Donation Awareness Week 2022. Read the full story on blood.ca.
Emergency room nurse becomes two-time living donor
Julia shared her story as part of Living Donation Week. Recently, Julia started volunteering with BC Transplant. It’s her hope that her experience can inspire others to consider becoming living organ donors.
Part 2 of Dylan's story is in development. Stay tuned for release in 2023.
A mighty kind movement brought by the Orgamites
This global education program helps educate young children about organs and organ donation
Three pillars of education and conversation
There are three pillars of this conversation: organ donation, health, and acts of kindness. Three sets of resources were developed to fuel discussion in each of the three areas:
The Let's Get Mighty Healthy toolkit helps children learn how the health of their organs affects their overall health and helps make them aware of the concepts of organ donation and caring for others. As Orgamites creator Roydon Turner puts it, "It's important for children to have a better understanding of how broccoli is going to make their engine work better. Hopefully that will also then make it a little bit easier for parents to empower their children and make them captains of their own health".
The Mighty Kind Movement toolkit was created to encourage and inspire kids to take better care of one another and the environment, too. It's based on the belief that teaching children about altruistic behaviour, including organ donation, begins with talking about kindness.
Read the full background about the Orgamites and their arrival in Canada.
ODTC: Protecting trust and integrity in the organ donation and transplant system together
At Canadian Blood Services, success comes from working in collaboration and partnership with organ donation and transplantation system stakeholders. Partnerships with provinces and territories, organ donation organizations and transplant programs, patients, donors, donor families, clinicians, professional associations, researchers, administrators and academics are critical to advancing transformative changes in the ODT system.
As a key partner with the Organ Donation and Transplantation Collaborative (ODTC), we are supporting the Collaborative’s vision by providing subject matter expertise to three mission-critical projects including: pan-Canadian ODT Governance, Data System and Reporting, and Interprovincial Organ Sharing.
The team has also played a significant role in advancing two key projects funded that will help reduce missed donation opportunities and protect trust in the system.
The clinical practice guideline is expected to be published in a special edition of the Canadian Journal of Anesthesia, the official journal of the Canadian Critical Care Society in early 2023 alongside 20 or more additional manuscripts focused on defining and determining death in Canada.
This project led the development of pan-Canadian deceased donor definitions, minimum dataset and performance metrics as a foundation to improve national data quality. The feasibility of collecting each recommended data variable was validated through partnership with eight organ donation organizations.
Canadian Blood Services, the Canadian Institute for Health Information (CIHI), and Canada Health Infoway meet regularly to ensure these foundational system achievements align and are incorporated into the development of a national, electronic data collection platform led by CIHI and Infoway.
Project summaries for all ODTC-funded projects can be read here.
Working together to share knowledge around the globe
The Commonwealth Tribute to Life project officially launched in 2022. This program offers a unique opportunity to highlight the ongoing need to increase levels of organ and tissue donation and transplantation across the world. The project brought together the Commonwealth nations, sharing expertise within organ donation and transplantation, with the aim of saving more lives.
The project regularly hosted international webinars for sharing of knowledge and expertise throughout 2022 and will begin a new series in 2023. Visit the Commonwealth Tribute to Life project webpage for more information and resources.
Looking back at 2022: In the news...
Alberta announces program to reduce missed donation opportunities
The Alberta ministry of health announced $2-million in funding for the Specialist in End-of-Life Care, Neuroprognostication and Donation (SEND) program. The program is focused on hiring specialists responsible for coordinating organ donation and transplantation opportunities by being on-call 24/7 to improve identification of potential donors and support families considering consent. The SEND program is meant to help ensure opportunities for donation are not missed. Read the announcement here.
The U.K. is reporting that the number of families agreeing to organ donation has dipped for the first time in years
Even though the law around organ donation has now changed to a deemed consent system across England, Scotland and Wales, family members will still always be consulted before organ donation goes ahead. Families were far more likely to support donation when they already knew it was what their relative wanted.
COVID-19 vaccine rules for organ transplant are about aiming for 'best possible outcome': experts say
“We strongly support transplant program requirements for transplant candidates to receive COVID-19 vaccine prior to transplantation,” the Canadian Society of Transplantation said in updated guidance provided to the provincial organ donation organizations and regional transplant programs.
Special drone delivery: The world-renowned Canadian taking organ transplants to new heights
There is obviously a long way to go before we exist in a world in which dozens of drones whizz overhead throughout the day, delivering life-saving organs across the country.
But Keshavjee is adamant that this is the future: a world in which the capacity for transplants is ramped up because drones can deliver the organs faster and cheaper. He believes “organ transplantation can be like a hip replacement.”
U.S. man who got first pig heart transplant dies after two months
David Bennet's son praised the hospital for offering the last-ditch experiment, saying the family hoped it would further efforts to end the organ shortage.
Can an equation to help determine kidney health be racist?
Many equations and guidelines adjust for race, and while it is sometimes a convenient proxy, critics say doing so reinforces stereotypes and that alternatives could yield more precise results.
Mayor gives key to city to parents of Humboldt player whose organ donation began a movement
In an emotional ceremony at Winnipeg city hall, Bernadine and Toby Boulet were presented with a key to the city in honour of their advocacy for organ donation.
Government of Canada invests $2-million for research on innovative organ and tissue donation projects
The Government of Canada recognizes that too many people in Canada are on organ waitlists, and that Canada lags in organ donation compared to other high-performing countries.
Charter not violated in denying transplant to patient who refused COVID-19 vaccine, court rules
Court of Queen's Bench Justice Paul Belzil ruled the charter has no application to clinical treatment decisions and, in particular, has no application to doctors establishing criteria for organ transplantation.
Western University researchers call for end to mandated anonymity in organ donation
Policies that prevent the families of deceased organ donors from identifying organ recipients is "outdated and unfair", several Western University researchers say.
Organ donations remain a hard sell among some groups
According to 2017 study, families of immigrants in Ontario are less likely to provide consent for organ donation compared with families of longterm residents (46.4 per cent versus 68.8 per cent). Another study shows that immigrants were much less likely to register for deceased organ and tissue donation in Ontario (11.9 per cent versus 26.5 per cent).
Scientists change blood type of kidney in breakthrough to speed up transplants
British scientists managed to change the blood type in three donor kidneys, which could potentially speed up transplants for patients with less common blood types, such as ethnic minorities.
"I'm so thankful": Barrie man nearly missed vital organ transplant due to Rogers outage
The Toronto lung transplant program out of the Ajmera Transplant Centre reached out to local medical officials and police in order to make contact with Attridge, who was waiting on a lung transplant.
Leaving the pandemic behind: Kidney March participants gather for 13th annual fundraiser
The Kidney March is back in full form for its 13th annual outing after a couple of years of doing things a little bit differently in the face of the pandemic.
First ever partial heart transplant saves five-month-old: 'Revolutionary' for other kids
Using a procedure that had only been performed successfully on pigs, surgeons transplanted parts of a donor heart into Owen Monroe's heart, saving his life.
Revival after death: New transplant procedure challenges ethics rules
Restarting hearts or restoring blood flow to organs is outlawed in some jurisdictions, and has medical ethicists split over whether it violates the dead donor rule.
We thank all system collaborators and partners, our colleagues at provincial organ donation organizations, 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 continue to work together 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 welcome 2023 and all the opportunity it presents, we look forward to our deepened collaboration, both in person and virtually, to improve the OTDT system in Canada for patients and their loved ones. We are confident that whatever we face in 2023 – we will continue to make all the difference together.
- The OTDT team at Canadian Blood Services
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.
