Consider organ donation

Times Contributor 

 

In ancient times the end of harvest and winter snows brought a time to re-evaluate issues and fears surrounding life and death. It still remains a topic today, and is something that should be discussed with loved ones. Part of that discussion can include wishes regarding organ or tissue donation.

“I think it should be part of our culture, in the same way as our DNR (do not resuscitate) orders are discussed,” said Dr. Andreas Kramer, the Director for the Southern Alberta Organ and Tissue Donation program

Organs that are donated usually come from people who have died through brain trauma or stroke. Brain death is defined as the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). Patients go through a series of neurological tests to confirm brain death. 

In Alberta, organs are harvested from brain dead patients. Tissue donation can be done after the heart and lungs stop working and death occurs. There are over 700 people in Alberta waiting for organ transplants and many others whose lives could be improved by tissue donation. There are two centres in Alberta, one in Calgary and the other in Edmonton. The programs deal with organ donation, ocular tissue donation which includes eyes, and non-ocular tissue donation, which includes skin, heart valves, and bone.

“There are a lot of people who are on liver and kidney transplant list not getting organs and to a lesser extent heart and lungs. There continues to be a pretty large discrepancy for the need for organs and the availability of organs. The main message is the number of people that are being helped by that process (organ donation). An organ donor can save lives, or radically impact or save the lives of seven or eight individuals and a tissue donor can help up to 50 people, “said Kramer. “The shortages in tissue donation are not as much of a crisis as organ donations, but we certainly have a long list of people waiting for cornea transplants and in Alberta.  We have recently had to purchase them from elsewhere because our own supply isn’t large enough to meet our demand. Increasingly people need cartilage transplants for their knee or one of their joints.”

In Alberta, organ donations have declined. On Oct. 28 of this year, Kramer and some of his peers released the results of a study on brain death, which was investigated in Edmonton over a ten year period. The study concluded the instances of brain injured patients experiencing neurological death was declining. Modern road safety measures, protective equipment and safe practises in recreational activities and improved pre-hospital and in-hospital care have had an effect. The doctors encouraged continued promotion of these measures to save lives.

The study is definitely good news for all Albertans, but the flip side of the issue is there are less organs being harvested to save those who need them. The other problem is not all organs or tissues are suitable for donations. 

“It is a major concern for us; unfortunately, we do have to be restrictive and so just because somebody wants to be a tissue donor and they have made that clear to their loved ones before they die, they may not be able to be a tissue donor for exactly those reasons. It is all carefully screened after they die, to see if they can be a candidate or not. We adhere, in Calgary, just like in other centres, to guidelines put out by Health Canada and the Academy of Tissue Banks and Eye Banks,” said Kramer.

He said that those who do qualify for donation are treated in the same manner as other patients; everyone gets the best care possible to ensure they recover. If there are no other options left, then families may be approached.

“Before we recover organs or tissue, we require informed consent. People can say no and they should have the right to say no. We try our best to invite them to have an open mind and take a little time to discuss it. We often arrange to have one of their faith leaders involved in the discussion,” said Kramer. “The scenario where someone might have checked off the back of their license, or expressed that they would like to be a donor, and the family comes back and disagrees, that does not happen very often. People have the misconception that it is an issue. More often we have families that have never talked about it and don’t know what the person wanted.” 

There are some measures being taken in Alberta to improve donation numbers. One is a provincial donation registry where permission is given when licenses are issued. Bill 207 in the Provincial legislature for the registry has passed second reading. The second measure that is gaining success is live organ donation, where a person chooses to donate a kidney, part of their liver or stem cells to those in need.

“One success story is the rates of kidney donation have gone up, and the reason we have seen them go up is we are getting more living donors than usual. Those who want to give one of their kidneys to someone,” said Kramer. “You only need one of your kidneys. Kidney donors do well. It is rare for them to develop kidney problems down the road.”

Kramer said the consequences of live donation do need to be considered, as there are some surgical risks and considerations about possible injury through trauma down the road. He said there is some work being done to improve viability of organs outside the body, where organs can be maintained and revitalized through mechanical means and he expects future developments in the technology will be promising.

Those that want more information about donation can go to www.albertahealthservices.ca and search organ transplantation or tissue donation, contact the call the HOPE program at 1-866-407-1970, or send an email to UAH_Hope@albertahealthservices.ca