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Organ donation specialists may increase organ donations in Canada

The integration of donation physician specialists into hospital teams in Canada could help increase organ donations, states a commentary in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.130050

Deceased donation rates in Canada are well behind those in many other countries with advanced organ transplant programs. These low rates mean that many patients die before a donor is found; in 2010, 16% of transplant candidates died awaiting a kidney, pancreas or both; 19% of lung transplant candidates, 22% of liver transplant candidates and 24% of heart transplant candidates died before a match was found

Donation physician specialists are usually critical care specialists who have expertise in organ and tissue donation. The United Kingdom, Australia, Spain and parts of the United States have donation physician programs, although the roles of the physician specialist vary by country, from directly caring for donors to administrative roles.

"Donation physician programs are associated with improvements in deceased donation rates," writes Dr. Sam Shemie, Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, with coauthors. "In Spain, the role is credited with increasing the donation rate to more than 30 donors per million population; this is one of the highest rates in the world."

In 2011, Canadian Blood Services recommended introducing donation physician specialists as part of a plan to increase the rates of organ donation and transplantation in Canada.

However, there is concern over potential conflict of interest with donation physician specialists who provide direct care in the intensive care unit and have a role in organ donation. Most programs separate the roles of donation team members from providing end-of-life care.

"A recommendation from expert consultation on donation and transplantation cohosted by Canadian Blood Services and the Canadian Critical Care Society in 2011 is that there be clear definition and separation of the roles of all people involved in the donation and transplantation system and transparency through full disclosure of roles and responsibilities to families and other professionals," the authors conclude. "Funding mechanisms should support giving patients an opportunity to donate without creating incentives to increase the number of organs donated through undue pressure."

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About Canadian Blood Services
Canadian Blood Services is a national, not-for-profit charitable organization that manages the supply of blood and blood products in all provinces and territories outside of Quebec. Canadian Blood Services also oversees the OneMatch Stem Cell and Marrow Network, and provides national leadership for organ and tissue donation and transplantation. Canadian Blood Services operates 42 permanent collection sites and more than 20,000 donor clinics annually. The provincial and territorial Ministries of Health provide operational funding to Canadian Blood Services. The federal government, through Health Canada, is responsible for regulating the blood system.

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Media Contact for interviews for Dr. Sam Shemie:

Cindy Winegarden
Regional manager, Public Affairs Ontario
Canadian Blood Services
Tel: 905-304-7471
Cell: 905-869-5988
Email: cindy.winegarden@blood.ca

General media contact:

Kim Barnhardt
Senior Strategist, Communications and Partnerships
CMAJ
Tel: 613-520-7116 x2224
Email: kim.barnhardt@cmaj.ca


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